Quality and Multifunctionality in Mobile Apps for Gestational Diabetes: Systematic App Review.

Background: The use of mobile health (mHealth) apps can assist with the management of gestational diabetes (GDM). Although a number of studies have demonstrated their efficacy in improving maternal-fetal outcomes, opinions differ regarding their usability and overall quality. Poorly designed apps, with ill-conceived features or inappropriate content, may pose a threat to patient safety. Nevertheless, very few studies provide in-depth evaluations of app design quality, and the diversity of features and techniques used remains insufficiently explored. Objective: We aimed to evaluate the quality and multifunctionality of commercially available mHealth apps for GDM. Methods: This is a systematic app review guided by the TECH (target user, evaluation focus, connectedness, and health domain) framework and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist. Searches were conducted on the Apple App Store and Google Play. Apps were screened by name, description, and full navigation to identify inclusions. The quality of the apps was evaluated using the Mobile App Rating Scale and IMS Institute for Healthcare Informatics Functionality Score. Multifunctionality of the apps was evaluated using the GDM-adapted features and techniques list developed from the App Behavior Change Scale, NICE (National Institute for Health and Care Excellence) 2015 guidelines, and previous studies. The general features list, which contains instruction, data security, customization, and technical issues, was derived from previous studies. Results: The search (June 2024) identified 23 commercially available apps from UK app stores. The overall app quality was evaluated to be satisfactory (Mobile App Rating Scale: mean 4.0, SD 0.36; IMS Institute for Healthcare Informatics Functionality Score: mean 5.83, SD 3.03). The multifunctionality evaluation found that the apps had a mean of 17.95 and SD of 7.31 across all 45 items. Overall, our findings suggested that mHealth apps for GDM achieved a certain level of multifunctionality. However, their feature types and supporting digital techniques are relatively basic. The apps focused on education and managing blood glucose control rather than integrating other self-monitoring data and pregnancy-relevant management into their design. The digital techniques used to achieve these features included text and manual operation, rather than other automated features. Conclusions: This is the first app review to consider the relationship between app features and usability for women with GDM. Future app development should integrate a wide range of pregnancy-relevant information and more automated features and use advanced digital techniques to enable a holistic digital solution for women with GDM.