Diabetes self-management app intellin® is a cost-effective solution for preventing diabetic foot ulcer recurrence

A study published in the journal Digital Health has found that the intellin® mHealth diabetes management platform is a cost-effective solution for managing and preventing the recurrence of diabetic foot ulcers[i]. The study assessed patients at Salford Royal NHS Foundation Trust, with 197 patients assessed for eligibility and 15 entering the full analysis set.

Patients in the study were able to input and track aspects of their diabetes management that might impact their foot health, including blood glucose levels, body mass index (BMI), blood pressure, and cholesterol levels. This data allowed intellin to intelligently forecast their DFU risk factors, as well as providing daily tips concerning appropriate foot care and managing diabetes and diabetes-related complications. An SOS button also allowed patients to rapidly self-refer to the SRFT foot care team for an urgent appointment.

The results of the feasibility and accessibility study combined with an HEOR evaluation suggest that intellin needs to only provide a 5% reduction in DFU recurrence compared to the current standard of care to be cost-effective. This suggests that wider adoption of intellin^Ò across the NHS would lead to significant healthcare cost savings. Initial qualitative data also showed that intellin scored highly on acceptability and usability for patients and clinicians, with a high likelihood of recommendation for future use.

Paul Chadwick, associate author, and Clinical Director at the Royal College of Podiatry, said: “Our study reflects the growing push towards more patient activation and involvement in their own care, as set out in the NHS Long Term Plan. Technology like intellin really allows patients to educate themselves and take on an active role in managing their risk for recurring diabetic foot ulcer, and the enthusiasm for the technology we reported in the study from both patients and healthcare professionals shows how much this is appreciated. I hope to see wider adoption of technology like this in the NHS, especially as the agenda for increasing the use of artificial intelligence in diabetic foot ulcer care continues to grow.”

Diabetic foot ulcer (DFU) is a common diabetes complication, and factors that increase the likelihood of developing DFU include poor glycaemic control over an extended period, peripheral arterial damage, and poor foot care. Correct diabetes management, especially after having at least one DFU, can significantly reduce the likelihood of DFU recurrence, and faster referrals lead to fewer severe ulcers and improved outcomes at 12 weeks[ii].

This UK study found that in the first year after a clinically infected index DFU, 15.1% of patients died, 17.4% had a lower extremity amputation, and 9.6% experienced a DFU recurrence. Severe DFUs are associated with a four-fold increased risk of amputation, and ~40% of people with diabetes do not survive more than five years after a DFU.

The intellin diabetes management platform, developed by Manchester-based digital health start-up Gendius, uses personal health data to forecast individual risk for developing specific diabetes complications. Built around the nine key care processes for diabetes, intellin also includes specific software to promote engagement with DFU services and expedite the self-referral process. Unlike other diabetes management apps, intellin goes beyond basic tracking and education to provide active monitoring and facilitates proactive care through a healthcare provider dashboard and rapid referral requests.

[i] Haycocks S, Cameron R, Edge M, Budd J, Chadwick P. Implementation of a novel mHealth application for the management of people with diabetes and recently healed foot ulceration: A feasibility study. DIGITAL HEALTH. 2022;8. doi:10.1177/20552076221142103

[ii] https://files.digital.nhs.uk/90/0A80E6/NDFA%20Interval%20Review%202014-21%20-%20Main%20Report%20v1.2.pdf