Review: Menopause apps need osteoporosis content, expert insight and simplicity
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Key takeaways:
- Fifty-seven percent of reviewed smartphone apps had educational osteoporosis content.
- Menopause app readability was complex and best understood by university graduates vs. those with less education.
Current menopause smartphone apps require more information on osteoporosis, expert input and better quality, functionality and simplicity of use and understanding for the general public, researchers reported.
Menopause significantly increases the risk for developing osteoporosis. Because of this, menopause smartphone apps should contain information on osteoporosis and provide an efficient way to manage, track and understand menopause, according to Deborah Paripoorani, MS, senior clinical research nurse for the EMERGING Research Team at the Manchester Royal Infirmary, U.K., and colleagues.
Paripoorani and colleagues conducted a systematic review, published in BMC Women’s Health, of 28 English-language smartphone apps focusing on menopause from the U.K. Apple and Google Play stores. Researchers evaluated the quality and functionality of each app using the Mobile App Rating Scale and IMS Institute for Healthcare Informatics functionality score and assessed whether the app had osteoporosis content or not.
Overall, 64% of reviewed apps aimed to educate their users and 87% were journals wherein the users kept a record of menopause-related feelings and symptoms. Three of the apps were designed to calculate risk, three were designed for community interaction, one shared menopause-related news and one was designed to manage menopause symptoms via hypnotherapy.
Researchers noted that more than half (57%) of the menopause apps included educational osteoporosis content. This content usually included a definition of osteoporosis, what it is, the higher risk one holds during menopause, ways to prevent osteoporosis, lifestyle changes, and the importance of supplements, hormone replacement, building up bone strength and strength training.
In addition, the readability of the apps, as assessed through Flesch-Kincaid metrics, was complex and best understood by university graduates vs. the general public. The average functionality score of all reviewed apps was 4.57 out of 11, and the most common functions were to inform (93%) and record and collect data (61%). The average quality score was 3.1 out of 5, with an average score of 2.98 for engagement, 3.3 for functionality, 3.1 for aesthetics and 3 for information.
“The readability of the apps needs to be simple for the general public to understand the content better. Additionally, collaboration with medical experts, user-centered design approaches and formal trials are required to ensure that content is appropriate and to test their usability and acceptability,” the researchers wrote. “This will help to ensure that there are reliable and good quality apps in the market to support healthy aging.”
Perspective
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JoAnn E. Manson, MD, DrPH, MACP
This is a sobering review that suggests most menopause apps fall short in meeting women's needs. Perimenopause and menopause are stages of women's life when biological aging accelerates risks for many health conditions, including adverse cardiometabolic outcomes, and body composition changes, bone loss and osteoporosis, and other health concerns increase. These issues are often given minimal attention during routine clinical visits, and many clinicians receive inadequate training in menopause management during medical school, residency, and other clinical educational programs.
Mobile apps have the potential to empower women by providing important health information, motivating them to make behavioral and lifestyle changes, and facilitating shared decision-making with their health care providers. However, many of the available apps — based on this systematic review — have overly complex language, lack functionality, and lack content on key health conditions such as osteoporosis.
Specifically, for osteoporosis, these apps would have the potential to inform women about what it is, why bone loss is related to menopause, key risk factors and ways to prevent it, and to provide tools for risk self-assessment and guidance on when to begin DXA screening, and also promote shared decision-making with health care providers regarding treatment.
It is important for women to understand that strategies are available to slow bone loss and reduce the risk for osteoporosis. We know the importance of regular physical activity, especially weight-bearing activity, strength training, adequate calcium and vitamin D, not smoking, avoiding excess alcohol and other risk factors.
These apps have the potential to empower women by informing them of ways to take charge of their health to reduce the risks for osteoporosis, type 2 diabetes, cardiovascular disease and several cancers and to become more informed about their health and more engaged in their health care. This isn't happening. In the study, more than 40% of the apps lacked osteoporosis content, and most apps had serious limitations.
It's also important that menopause apps provide information about assessing menopausal symptoms and options for management, address key factors in decision-making about hormone therapy consistent with existing professional guidelines, inform women of the availability of hormonal and non-hormonal treatment options and provide information to help women participate in shared decision-making with their clinicians.
Overall, it's clear that there's room for improvement in app development. Importantly, there needs to be active involvement of content experts to ensure the information is reliable, and apps need to have easily understandable language and high functionality. It can be helpful to have intended users assist with the design and participate in focus groups to provide feedback on functionality and usefulness. Such steps should lead to apps that are of greater benefit to menopausal women and other target patient populations. Menopause apps have the potential to improve women’s health during a key life stage characterized by escalating health risks, often inadequate attention to menopause-related health concerns in clinical settings, and clear benefits from more active engagement of women in their health care and treatment decisions.
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