Digital Medicine Tools and the Work of Being a Patient: A Qualitative Investigation of Digital Treatment Burden in Patients With Diabetes

Abstract

Objective: To understand the contribution of digital medicine tools (eg, continuous glucose monitoring systems, scheduling, and messaging applications) to treatment burden in patients with diabetes. Patients and Methods: Between October and November 2023, we invited patients with type 1 or type 2 diabetes to participate in semistructured interviews. The interviewees completed the Treatment Burden Questionnaire as they reflected on how digital medicine tools affect their daily routines. A published taxonomy of treatment burden guided the qualitative content analysis of interview transcripts. Results: In total, 20 patients agreed to participate and completed interviews (aged 21-77 years, 55% female, 60% living with type 2 diabetes). We found 5 categories of tasks related to the use of digital medicine tools that patients had to complete (eg, calibrating continuous glucose monitors), 3 factors that made these tasks burdensome (eg, cost of device replacements), and 2 categories of consequences of burdensome tasks on patient wellbeing (eg, fatigue from device alarms). Conclusion: Patients identified how digital medicine tools contribute to their treatment burden. The resulting digital burden taxonomy can be used to inform the design, implementation, and prescription of digital medicine tools including support for patients as they normalize them in their lives.