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The evidence behind DiAlgo, and its limits

DiAlgo does not yet have studies of its own, and we would rather say so than hint otherwise. What it does have is a design grounded in published research. Here each idea appears with what the study found, what we did with it in the app and what cannot be claimed.

Medication

On average, only half of prescribed doses are taken

What the research found
The Cochrane review on adherence starts from a figure repeated across the literature: people who self-administer their medication typically take about half of their prescribed doses. In a meta-analysis of 16 randomised trials, mobile text reminders doubled the odds of adhering to treatment (odds ratio 2.11; 95% CI 1.52–2.93). 12
What DiAlgo does with it
DiAlgo sends an alert at the time of each dose and the person marks it as taken with one tap. The family can see whether it was marked, so the reminder does not depend on someone calling to ask.
Limits
In that meta-analysis the median age was 39, adherence was mostly self-reported and interventions lasted about 12 weeks. The Cochrane review itself reports a lack of convincing evidence even among the trials at lowest risk of bias.

Contact

Social isolation weighs as much as other well-known risk factors

What the research found
A meta-analysis of mortality data associated social isolation, loneliness and living alone with a 29%, 26% and 32% higher likelihood of death, respectively. A review of 25 studies found that communication technologies consistently improve older adults’ social support and sense of connectedness. 345
What DiAlgo does with it
Sending a “Good morning” takes one tap. We cut the effort of checking in to the minimum so contact happens daily and does not depend on being able to type.
Limits
That same review notes the effect did not last beyond six months and that results on loneliness are inconclusive. A later meta-analysis found no evidence that digital interventions reduce loneliness in older adults. DiAlgo makes contact easier; it does not replace visits or company.

Design

What holds older adults back is not lack of interest but complexity

What the research found
In focus groups with people aged 65 to 76 with no tablet experience, most wanted to learn. The barriers they named were unclear instructions, lack of confidence, technology that is “too much and too complex”, and fear of feeling inadequate. Button size and spacing on touch screens for older adults have been studied experimentally, and WCAG 2.2 sets a minimum of 24 × 24 CSS pixels for any control (level AA). 789
What DiAlgo does with it
The older person sees a single screen with a few very large buttons, each with its own colour, icon and sound. There are no menus and no mandatory keyboard, and the family sets the app up from their own phone.
Limits
The qualitative study had 18 participants. DiAlgo has not been through an external accessibility audit: we apply these guidelines as design criteria and do not claim certified conformance.

Family

Caring alone is a risk factor for the caregiver

What the research found
A clinical review published in JAMA lists among the risk factors for caregiver burden the number of hours spent caring, social isolation, depression and lack of choice in becoming a caregiver. The WHO report on ageing and health defines healthy ageing as the process of developing and maintaining the functional ability that enables well-being in older age. 610
What DiAlgo does with it
Check-ins reach the whole family, not just one person. Anyone can see what happened and how many have read it, and share out the response.
Limits
The review describes mild to modest efficacy for the interventions it assessed, which were mainly psychosocial, not apps. Sharing information is a reasonable choice, not a demonstrated effect of DiAlgo on caregiver burden.

How we chose the sources

  • We prioritise systematic reviews and meta-analyses over single studies, and technical standards over third-party recommendations.
  • The figures are the ones the authors publish in each article’s abstract. We do not round them in our favour or extrapolate them to DiAlgo.
  • Every reference links to its DOI or official page, so anyone can check it.
  • Where the evidence is weak or contradictory, we say so in the same place we cite it.

References

  1. Nieuwlaat R, Wilczynski N, Navarro T, et al. (2014). Interventions for enhancing medication adherence. Cochrane Database of Systematic Reviews, (11), CD000011. doi:10.1002/14651858.CD000011.pub4 Systematic review · 182 trials
  2. Thakkar J, Kurup R, Laba TL, et al. (2016). Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. JAMA Internal Medicine, 176(3), 340–349. doi:10.1001/jamainternmed.2015.7667 Meta-analysis · 16 trials, 2,742 patients
  3. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. doi:10.1177/1745691614568352 Meta-analysis
  4. Chen YR, Schulz PJ. (2016). The effect of information communication technology interventions on reducing social isolation in the elderly: a systematic review. Journal of Medical Internet Research, 18(1), e18. doi:10.2196/jmir.4596 Systematic review · 25 studies
  5. Shah SGS, Nogueras D, van Woerden HC, Kiparoglou V. (2021). Evaluation of the effectiveness of digital technology interventions to reduce loneliness in older adults: systematic review and meta-analysis. Journal of Medical Internet Research, 23(6), e24712. doi:10.2196/24712 Meta-analysis · 6 studies, 646 participants
  6. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. (2014). Caregiver burden: a clinical review. JAMA, 311(10), 1052–1060. doi:10.1001/jama.2014.304 Clinical review
  7. Vaportzis E, Giatsi Clausen M, Gow AJ. (2017). Older adults perceptions of technology and barriers to interacting with tablet computers: a focus group study. Frontiers in Psychology, 8, 1687. doi:10.3389/fpsyg.2017.01687 Qualitative study · 18 participants
  8. Jin ZX, Plocher T, Kiff L. (2007). Touch screen user interfaces for older adults: button size and spacing. Universal Access in Human-Computer Interaction (LNCS 4554), 933–941. Springer. doi:10.1007/978-3-540-73279-2_104 Experimental study
  9. World Wide Web Consortium (W3C). (2023). Web Content Accessibility Guidelines (WCAG) 2.2. W3C Recommendation. www.w3.org/TR/WCAG22/ Technical standard
  10. World Health Organization. (2015). World report on ageing and health. Geneva: WHO. www.who.int/publications/i/item/9789241565042 Report

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