User Engagement With the CamAPS FX Hybrid Closed-Loop App According to Age and User Characteristics
Natalie S. Chen, Charlotte K. Boughton, Sara Hartnell, Julia Fuchs, Janet M. Allen, Malgorzata E. Willinska, Ajay Thankamony, Carine de Beaufort, Fiona Campbell, Elke Fröhlich‐Reiterer, Sabine E. Hofer, Thomas Kapellen, Birgit Rami‐Merhar, Atrayee Ghatak, Tabitha Randell, Rachel Besser, Daniela Elleri, Nicola Trevelyan, Louise Denvir, Nikki Davis, Eleanor Gurnell, Robert S. Lindsay, Damian Morris, Eleanor Scott, Lia Bally, Hood Thabit, Lalantha Leelarathna, Mark L. Evans, Helen Murphy, Julia K. Mader, Roman Hovorka
Abstract
CamAPS FX (CamDiab, Cambridge, U.K.) is a hybrid closed-loop app hosting the Cambridge closed-loop algorithm on an Android smartphone, and it is approved in the European Union for use in children ≥1 year and adults (including during pregnancy) with type 1 diabetes (T1D). The interoperable CamAPS FX app receives glucose data from a compatible continuous glucose monitoring system (Dexcom G6; Dexcom, San Diego, CA), connects to a compatible insulin pump (Dana Diabecare RS and DANA-i; Sooil, Seoul, South Korea) to direct glucose-responsive insulin delivery every 8–12 min, includes a bolus calculator allowing discrete bolusing via the app, and streams data in real time to cloud-based diabetes data repositories (Diasend/Glooko, Gothenburg, Sweden). It is currently unknown how much time different user cohorts spend interacting with hybrid closed-loop systems. We aimed to investigate usage patterns of the CamAPS FX app across different populations by considering the amount of time a person spends using the app over a 24-h period. We noted time spent within the CamAPS FX app over an 11-week period from February to May 2020 in 134 individuals from six ongoing clinical studies. Each study involved a different demo graphic cohort: very young children (1–7 years) in which caregivers use the app (NCT03784027, ClinicalTrials.gov), children and adolescents (6–19 years) (NCT02925299), adolescents (10–17 years) using the closed-loop system from diagnosis of T1D (NCT02871089), adults (≥18 years) (NCT04055480), pregnant women (≥18 years) (ISRCTN56898625, www.isrctn.org), and older adults (≥60 years) (NCT04025762). All studies received regulatory and ethical approval; participants/guardians signed informed consent. User engagement is the duration of time that users have the application active and in the foreground, as calculated by an analytics cloud platform (Firebase; …