Strengths and limitations
diabetes
HYPOGLYCAEMIA, RECRUITMENT, ADVERSE EFFECTS, HYPERGLYCAEMIA, DIABETES
In addition to the findings discussed above, this study highlights the challenges of implementing interventions in real-world settings. Originally, our intention was to include 100 participants in the study. However, the widespread development of Covid-19 within society presented obstacles that hindered the recruitment of study subjects. The drop-out rate of 9.6% is not high for a clinical trial but does limit the generalisability of the findings. Furthermore, the study had a relatively short follow-up period of 6 months, and it is possible that longer-term follow-ups would reveal other outcomes.The number of participants was limited, and some outcome differences may have been undetected. There was a skewed distribution in educational level between the randomized groups, and it was significantly lower among those participating in the intervention. Therefore, some positive effects of the intervention could have been underestimated.Like any other questionnaire, the DTSQ has its limitations. One of these limitations is referred to as the ‘ceiling effect’. If a patient’s baseline DTSQ score is high enough, it may be challenging to detect any further improvements in treatment satisfaction following an intervention. Conversely, if the scores for Question 2 (‘hyperglycaemia’) or Question 3 (‘hypoglycaemia’) are low enough at baseline, it may be challenging to detect any decrease after intervention. This is an example of the ‘floor effect’.Due to the vast array of technologies and applications included in digital-based interventions, it is challenging to draw broad conclusions from any single study. Despite numerous investigations into the effectiveness and usability of different tools and approaches, systematic reviews and meta-analyses have been unable to offer conclusive guidance because of variations in study designs, observation periods, study populations and the specific tools/technologies examined.Despite these limitations, this study provides valuable information on the impact of the intervention on quality of life and suggests that interventions targeting non-traditional outcomes may have value. It is also worth noting that the intervention did not have any adverse effects, indicating that it is a safe option for people with diabetes.