DEVELOPMENT AND EVALUATION OF A NOVEL MOBILE-BASED SMARTPHONE APPLICATION FOR DIABETIC FOOT ULCER CARE USING REGULAR WOUND PHOTOGRAPHS, VIDEOS, AND CHAT-BASED COMMUNICATION TO PREVENT COMPLICATIONS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: 

Diabetic foot ulcers (DFUs) are a leading cause of lower-limb amputation, disability, and mortality in patients with diabetes. Poor follow-up, inadequate monitoring, and delayed intervention are major contributors to complications.

Objective: To evaluate the efficacy of a novel mobile-based smartphone application for DFU care compared with conventional follow-up in improving ulcer healing, reducing complications, and enhancing adherence.

Methods: A single-center, prospective, randomized controlled trial was conducted involving 60 diabetic patients with Wagner grade 1–4 foot ulcers. Participants were randomized into two groups: the intervention group (n=30) received the mobile application for daily wound image/video uploads, automated reminders, and direct chat with clinicians; the control group (n=30) received standard outpatient care. Outcomes measured over 24 weeks included ulcer healing rate, healing time, medication adherence, and glycemic control (HbA1c levels)

Results: Complete ulcer healing occurred in 50% of app users compared to 16.7% in the control group (p=0.0346). Mean healing time was significantly shorter in the intervention group (11.85 ± 4.57 weeks) compared to controls (13.17 ± 4.79 weeks, p=0.0001). Medication adherence was significantly higher in the intervention group (89.86% ± 5.67) compared to controls (66.6% ± 10.25, p<0.0001). No significant difference was observed in final HbA1c, though trends favored the intervention group.

Conclusion: The novel mobile application significantly improved ulcer healing rates, reduced healing time, and enhanced medication adherence. Digital health solutions hold promise as adjunctive tools in DFU management, particularly in resource-limited settings.