Mobile Health App Needs Among Patients With Diabetic Foot Ulcers in China: A Qualitative Study From the Perceptions of Patients, Caregivers, and Health Care Professionals

Clinical Snapshot

Key Findings

• P Value: Not applicable — qualitative study

• Effect Size: Not applicable — qualitative study; no quantitative effect sizes reported

• Primary Outcome: Five themes characterising mHealth app needs: (1) pressing need to implement mHealth app services; (2) convenient and personalised access to information; (3) continuous and specialised health guidance; (4) multidisciplinary approach to disease management; (5) free access alongside privacy and legal protections

• Nnt Or Sensitivity: Not applicable — qualitative needs-assessment study; no diagnostic, therapeutic, or prognostic metrics reported

• Confidence Interval: Not applicable — qualitative study

Clinical Application

The findings are directly applicable to the design phase of mHealth app development for DFU. Key feasibility considerations include: ensuring free or low-cost access to maximise uptake among patients with diabetes who may face financial burden; building in privacy and data security features to address legal and confidentiality concerns; incorporating multidisciplinary functionality (wound assessment, glycaemic monitoring, dietary guidance, podiatry input); and enabling asynchronous communication to support continuity of care between clinic visits. Implementation feasibility will depend on health system infrastructure, digital literacy of the target population, and regulatory approval of the app. Diabetic foot disease is a significant burden in Australia, with approximately 4,400 lower limb amputations performed annually, predominantly in people with diabetes (Diabetes Australia). The RACGP Standards for General Practice and the National Diabetes Services Scheme (NDSS) support integrated, multidisciplinary DFU management. The TGA regulates mHealth apps as Software as a Medical Device (SaMD) under the Therapeutic Goods Act 1989, and any DFU-specific app with diagnostic or therapeutic claims would require TGA registration. The PBS does not currently subsidise mHealth apps, making the study's finding regarding 'free access' particularly relevant to Australian health equity considerations. The Australian Digital Health Agency's National Digital Health Strategy 2023–2028 explicitly supports patient-centred digital health tools, aligning with the study's themes. However, direct transferability is limited by differences in healthcare system structure, cultural context, and the Chinese regulatory environment. Adults with diabetic foot ulcers receiving care in outpatient wound care settings, their informal caregivers, and the multidisciplinary HCPs involved in their management (nurses, physicians, podiatrists, dietitians)

Abstract

OBJECTIVE: To explore the specific needs of patients with diabetic foot ulcers (DFUs), caregivers, and health care professionals (HCPs) for a mobile health (mHealth) app, aiming to inform the design and development of effective mHealth service solutions. METHODS: This descriptive qualitative study was conducted from June to September 2024 in the wound care clinics of 2 local hospitals. Participants included patients with DFUs, caregivers, and HCPs directly involved in their care. Interview data were analyzed, synthesized, and refined using content analysis. RESULTS: Five key themes emerged: the pressing need to implement mHealth app services, convenient and personalized access to information, continuous and specialized health guidance, a multidisciplinary approach to disease management, and free access alongside privacy and legal protections. CONCLUSIONS: This study provides valuable insights for the design and development of an mHealth app for DFU. During the development process, it is essential to consider user needs and ensure the app meets the expectations of patients and related groups for personalized, continuous, and specialized health guidance; free access; privacy protection; and multidisciplinary collaboration. A balance should be struck between convenience and security of the app's features, to encourage user engagement and enhance the app's value and effectiveness.

References

1. 1.Yao, J.-L., Gu, Y.-J., Yin, Y.-Y., Yu, H.-P., & Zhuang, H.-R. (2026). Mobile health app needs among patients with diabetic foot ulcers in China: A qualitative study from the perceptions of patients, caregivers, and health care professionals. Advances in Skin & Wound Care. https://doi.org/10.1097/ASW.0000000000000477