Please use this identifier to cite or link to this item:
Title: Medication management apps for diabetes : systematic assessment of the transparency and reliability of health information dissemination
Authors: Huang, Zhilian
Lum, Elaine
Car, Josip
Keywords: Science::Medicine
Issue Date: 2020
Source: Huang, Z., Lum, E., & Car, J. (2020). Medication management apps for diabetes : systematic assessment of the transparency and reliability of health information dissemination. JMIR mHealth and uHealth, 8(2), e15364-. doi:10.2196/15364
Journal: JMIR mHealth and uHealth
Abstract: Background: Smartphone apps are increasingly used for diabetes self-management because of their ubiquity and ability to help users to personalize health care management. The number of diabetes apps has proliferated in recent years, but only a small subset of apps that pose a higher risk are regulated by governmental agencies. The transparency and reliability of information sources are unclear for apps that provide health care advice and are not regulated by governmental agencies. Objective: This study aimed to assess the transparency and reliability of information disseminated via diabetes apps against 8 criteria adapted from the Health On the Net code of conduct (HONcode) principles. Methods: English-language diabetes-related terms were searched on a market explorer (42matters) on June 12, 2018. Apps with medication and blood glucose management features were downloaded and evaluated against the App-HONcode criteria adapted from the 8 HONcode principles: authoritative, complementarity, privacy, attribution, justifiability, transparency, financial disclosure, and advertising policy. Apps were profiled by operating platforms (ie, Android and iOS) and the number of downloads (ie, Android only: ≥100,000 downloads and <100,000 downloads). Results: A total of 143 apps (81 Android and 62 iOS) were downloaded and assessed against the adapted App-HONcode criteria. Most of the apps on the Android and iOS platforms fulfilled between 2 and 6 criteria, but few (20/143, 14.0%) apps mentioned the qualifications of individuals who contributed to app development. Less than half (59/143, 39.2%) of the apps disclaimed that the information provided or app functions do not replace the advice of the health care provider. A higher proportion of iOS apps fulfilled 5 or more App-HONcode criteria compared with Android apps. However, Android apps were more likely to have the developer’s email listed on the app store (Android: 75/81, 98%; and iOS: 52/62, 84%; P=.005) compared with iOS apps. Of the Android apps assessed, a significantly higher proportion of highly downloaded apps had a privacy and confidentiality clause (high downloads: 15/17, 88%; and low downloads: 33/64, 52%; P=.006) and were more likely to discuss their financial sources (high downloads: 14/17, 82%; and low downloads: 32/64, 50%; P=.03) compared with apps with a low number of downloads. Conclusions: Gaps in the disclosure of the developer’s qualification, funding source, and the complementary role of the app in disease management were identified. App stores, developers, and medical providers should collaborate to close these gaps and provide more transparency and reliability to app users. Future work can further examine the consent-seeking process for data collection, data management policies, the appropriateness of advertising content, and clarity of privacy clause of these apps.
ISSN: 2291-5222
DOI: 10.2196/15364
Rights: © 2020 Zhilian Huang, Elaine Lum, Josip Car. Originally published in JMIR mHealth and uHealth (, 19.02.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

Files in This Item:
File Description SizeFormat 
document(2).pdf267.84 kBAdobe PDFView/Open

Citations 50

Updated on Jan 31, 2023

Web of ScienceTM
Citations 50

Updated on Jan 31, 2023

Page view(s)

Updated on Feb 6, 2023

Download(s) 20

Updated on Feb 6, 2023

Google ScholarTM




Items in DR-NTU are protected by copyright, with all rights reserved, unless otherwise indicated.