Protocol and registration

No protocol was registered for this scoping review. However, the methodology followed the Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting checklist. The JBI framework was selected over other scoping review approaches (such as the Arksey and O’Malley framework) because it provides comprehensive and up-to-date methodological guidance, including the use of the Population–Concept–Context (PCC) framework and structured data charting procedures.

Inclusion criteria

Studies were included if they described or evaluated mobile applications (apps) designed to support self-management among individuals with diabetic kidney disease (DKD) or diabetes or chronic kidney disease. Articles must report on at least one self-management-related feature integrated into a mobile app, such as health monitoring, patient education, motivational tools, or performance feedback. Only studies published in English were included. There were no publication year, study design, or geographic location restrictions.

More specifically, the inclusion criteria were:

1. i. Population: Adults diagnosed with type 2 diabetes and chronic kidney disease (CKD) or diabetic kidney disease (DKD). Studies focusing on patients with both conditions, or where DKD is clearly defined, will be included.
2. ii. Concept: The main focus is self-management interventions delivered via mobile applications. This includes features such as self-care monitoring, education, motivation, support, and performance incentives.
3. iii. Context: Studies conducted in any healthcare or community setting, with mobile applications (not limited by platform) used to support self-management among DKD patients. No geographic restrictions exist, as long as the study includes relevant app-based interventions.
4. iv. Types of Studies: This scoping review included interventional studies (both randomised and non-randomised), observational studies (such as cohort and cross-sectional designs), and studies describing the development phase of mobile apps. Protocol papers and conference abstracts were excluded. Studies focusing on healthcare personnel, caregivers, or family members rather than patients were also excluded.

Information sources

Five electronic databases were systematically searched: PubMed, Scopus, SAGE Journals, ScienceDirect, and Web of Science. In addition, reference lists of the included studies were also manually screened to identify additional eligible studies; however, none met the inclusion criteria.

Search strategy

A comprehensive search strategy has been developed using keywords and Medical Subject Headings (MeSH) related to diabetes, chronic kidney disease, diabetic kidney disease, self-management, and mobile applications. Each database has a tailored search strategy, and Boolean operators (AND/OR) were used to refine the search queries. All databases were searched from inception to 26^th February 2025, with no limits on language set. An example of the whole search string is included in S3 Table.

Study selection and data charting

All search results were imported into reference management software, Zotero, and duplicates were removed. Two reviewers independently screened titles and abstracts against the inclusion criteria. Full-text articles of potentially relevant studies were reviewed independently. Data charting was conducted using a standardised extraction form developed by the review team, which included predefined fields based on the review objectives and PCC framework. Discrepancies between reviewers have been resolved through discussion or consultation with a third reviewer when necessary.

Data extraction and synthesis

Relevant data were extracted into a structured form, including study characteristics, target population, mobile app features, technologies used, outcomes measures, and integration with care teams, if available. The data extraction form was developed by the review team based on the review objectives and the PCC framework, and was tested and refined during the initial stages of data extraction to ensure clarity, consistency, and reproducibility, in line with JBI guidance for scoping reviews.

Features identified from the included mobile apps were categorised into four functional domains: self-care monitoring, education, motivation and patient support, and performance incentives. Categorisation was guided by the primary function of each feature as described in the included studies and mapped to the predefined domain definitions developed by the review team. Where a feature addressed more than one function, it was assigned to the domain that best reflected its main intended purpose. Medication-related functionalities (such as medication reminders, adherence tracking, or insulin monitoring) were categorized under the self-care monitoring domain. Any uncertainties in categorisation were discussed among the review team and resolved by consensus.

Data items

The following data items have been charted:

1. i. Author(s), year of publication, and country of study
2. ii. Study design and setting
3. iii. Target population (e.g., type 2 diabetes with chronic kidney disease)
4. iv. Mobile apps name
5. v. Core functional and details of self-management features
6. vi. Technology used and usage of supportive technologies (e.g., sensors or wearables)
7. vii. Integration with care team and
8. viii. Outcomes measurement used

Quality assessment

Consistent with the scoping review methods and objective of this scoping review which are to identify and map the key features of mobile applications used for self-management among individuals with diabetic kidney disease, this study focused on providing a broad overview of the available evidence [9,10]. As per JBI guidelines, critical appraisal was not conducted, in line with the exploratory objectives of the review.

Study methods

The studies included in this review employed various research designs. Five studies utilized a randomized clinical trial (RCT) design [12–14,17,21] while three studies adopted user-centered or co-development approaches [11,15,20]. One study conducted a pilot validation [16] another employed a prospective cohort design [19] and one study carried out a descriptive technical validation [18].

Year of publication and target population

The included studies were published between 2014 and 2024, with a concentration of research conducted in the past five years from 2020 to 2024. The earliest study was by Hidalgo et al. [18] in 2014, while the most recent were published in 2024. The studies targeted patients with a range of chronic conditions, primarily focusing on chronic kidney disease (CKD), diabetic kidney disease (DKD), and type 2 diabetes mellitus (T2DM). As shown in Fig 2 specifically, five studies involved CKD patients [11,12,15,19], two focused on DKD patients [14,16] and four studies targeted individuals with T2DM [17,18,20,21]. One study [18] included both T1DM and T2DM patients. This diversity in target populations reflects the overlapping and interrelated nature of these chronic conditions in mobile health research.

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Fig 2. Number of studies by condition.

https://doi.org/10.1371/journal.pone.0331604.g002

Core functional domains of self-management features

Table 3 summarizes four recurring core functional domains of self-management features identified across the included studies. As shown in Table 3, self-care monitoring was present in ten studies, allowing users to track parameters such as blood glucose, blood pressure, and physical activity. Educational components were featured in seven studies, providing patients with disease-specific knowledge and lifestyle guidance. All eleven studies included patient support and motivational features, such as reminders, feedback, and communication tools. Lastly, performance incentive features, such as goal tracking and gamification, were incorporated in two studies [15,17] aimed at encouraging adherence and engagement.

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Table 3. Core functional domains across the 11 studies.

https://doi.org/10.1371/journal.pone.0331604.t003

Further details of the four key self-management domains identified across the included studies are presented in Table 4. These domains reflect the core functionalities integrated into mobile health interventions aimed at enhancing chronic disease self-management. Among the 11 studies, patient support and motivational features were universally implemented. These included reminders, personalized feedback, peer interactions, and clinician alerts tools known to enhance adherence and user engagement. Self-care monitoring was nearly as prevalent, appearing in 10 studies [11–21] with features such as self-monitoring blood glucose, blood pressure, pulse and activity tracking, which some supported by wearable technology.

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Table 4. Details of core functional domains for self-management, integration, and outcome measures.

https://doi.org/10.1371/journal.pone.0331604.t004

Educational content was incorporated in seven studies [11,15–20], delivered through interactive modules, videos, or structured text, supporting patient understanding of disease processes and lifestyle management. In contrast, performance incentives such as gamification or reward systems were reported in only two studies which one was conducted in United States [15] and the other in China [17].

Supportive devices used

In addition to the use of basic mobile applications, a limited number of studies incorporated other supportive devices to enhance the functionality and user experience of self-management interventions. Out of the eleven studies reviewed, four reported the integration of additional tools. One study utilized a heart rate wristband to monitor physical activity parameters such as steps taken, calories burned, and sleep patterns [13]. Two studies employed the LINE app group function to deliver dietary and exercise information and to facilitate teleconsultations [13,16]. Another two studies incorporated Bluetooth-enabled glucometers, allowing users to synchronize blood glucose data directly with the mobile application for continuous monitoring [14,21]. Study 6 [16] integrated communication features, including chat messaging and video calls, to provide real-time interaction and support. The remaining studies did not report the use of external supportive devices and relied solely on the mobile application’s built-in features.

Integration with care team and outcome measures

Among all the 11 studies, only a minority demonstrated active integration between the mobile apps and healthcare providers. Some apps (e.g., DialBetesPlus and SMARTDiabetes) synchronized data with electronic medical records or allowed care teams to monitor patient progress [14,17]. Others (e.g., e-KidneyCare) used built-in alerts to notify providers of critical lab results or symptoms [12]. However, most apps were standalone tools, lacking bidirectional communication or real-time clinician input. The included studies reported a range of outcome measures encompassing adherence metrics (such as medication compliance and goal tracking), biometric improvements (including blood pressure, HbA1c, and weight), and patient-reported outcomes related to usability and satisfaction [11,21]

Principal findings

This scoping review mapped the functional features of mobile applications designed to support self-management among individuals with DKD, T2DM, and CKD. From 3,521 records, eleven studies were included, reflecting increasing interest in digital self-management tools across diabetes and kidney-related conditions. Across these apps, four core self-management domains were identified: patient support and motivation, self-care monitoring, educational components, and performance incentives. Patient support and monitoring features predominated, while incentives and clinical integration remained limited.

Self-management feature domains

Patient support and motivational features were consistently incorporated across all reviewed apps. Common elements included reminders, personalized feedback, messaging, and peer-support components, reflecting a shift toward interactive and patient-centred app design. Such features are intended to enhance treatment adherence, reinforce healthy behaviours, and sustain engagement, consistent with prior evidence linking digital support mechanisms with improved self-management behaviours in diabetes and kidney care [1,22].

Self-care monitoring was another highly prevalent domain, reported in most studies. Apps commonly enabled tracking of blood glucose, blood pressure, body weight, and physical activity, either manually or through wearable device integration such as Bluetooth-enabled glucometers. These monitoring functions align with established clinical practices for managing diabetes-related complications and cardiovascular risk [2]. However, monitoring was often implemented as passive data collection, with limited linkage to individualized feedback or clinical decision support.

Educational components were present in approximately two-thirds of the apps, delivered through videos, structured modules, or quizzes. While these components aimed to improve disease knowledge, medication adherence, and lifestyle practices, their level of personalization varied substantially. Many apps relied on static educational content, highlighting a gap in adaptive learning approaches that respond to users’ changing needs and disease progression [23,24].

Performance incentives, including gamification and reward mechanisms, were the least commonly implemented features, reported in only two studies. Despite growing evidence that incentives can support motivation and sustained engagement, their limited use suggests that this design element remains underexplored in CKD and DKD-focused applications [3,25].

Supportive devices and integration with care teams

Only four apps incorporated wearable or supportive devices, and real-time, two-way communication with healthcare providers was described in just two studies. Although some apps enabled data sharing or automated alerts, most lacked interactive clinical integration. This represents a missed opportunity, particularly for chronic conditions requiring ongoing monitoring, medication adjustment, and multidisciplinary care. Integrated digital systems that facilitate structured communication between patients and healthcare teams may reduce care fragmentation and support continuity of care, as suggested by recent digital health evaluations [26,27].

Regional and contextual variation

Variation in mobile app features appeared to reflect both the target population and geographic context. For example, apps developed for diabetes populations generally emphasized glycaemic monitoring and lifestyle-related education, whereas CKD-focused apps placed greater emphasis on symptom tracking, renal-specific monitoring, and general wellness. Apps targeting DKD combined features addressing both glycaemic and renal management, reflecting the more complex self-management needs of this group. Regional differences were also observed, with some Asian-developed apps more likely to incorporate wearable device integration and messaging features. Together, these findings suggest that both clinical priorities and local technological infrastructure influence how mobile app functionalities are designed and prioritized. [11,13–21]

Outcome reporting versus effectiveness

Several studies reported outcomes related to adherence, glycaemic control, usability, and user satisfaction. However, this scoping review focused on mapping functional features rather than appraising effectiveness or synthesizing intervention effects. Heterogeneity in study designs, outcome measures, and follow-up durations limited meaningful comparison of effectiveness across studies. This descriptive approach is consistent with scoping review methodology and with prior reviews examining digital health app content and functionality [28].

Data security and ethical considerations

Mobile health applications handle sensitive personal and clinical data, yet reporting on data security and ethical safeguards was limited across the included studies. Safe and trustworthy use requires clear attention to informed consent, secure data storage and transmission, appropriate access control, and transparency in how user data are collected and used. Ethical considerations also include ensuring equitable access and usability for individuals with lower digital literacy. These practices are aligned with international digital health governance and mobile security standards, which emphasize privacy protection and user trust [29–31]. Improving the reporting and implementation of these safeguards is important for the wider adoption of mobile apps in chronic disease self-management.

Limitations

This review has several limitations. First, no formal quality appraisal was conducted, in line with Joanna Briggs Institute scoping review guidance, meaning that the methodological quality of the included studies may vary. Second, the review was limited to English-language publications indexed in selected databases, which may have resulted in the exclusion of relevant studies reported in other languages or in grey literature, such as app store descriptions, technical reports, or industry publications. Third, information on real-world app engagement, including download numbers, active users, and user retention, was not consistently reported in the included studies and therefore could not be analysed. In addition, details on app cost models (e.g., free, freemium, or subscription-based) were rarely reported, limiting assessment of affordability, equity, and practical use. Finally, this review focused on describing app features rather than evaluating clinical effectiveness. These limitations should be considered when interpreting the findings.

Implications for app development and clinical practice

The findings of this review highlight several implications for future mobile health development and research. App developers should consider not only self-management features but also transparency regarding pricing, cost models, and long-term affordability to support equitable access. Greater reporting of real-world usage data, such as user engagement and retention, would also strengthen understanding of app sustainability and practical value. From a clinical perspective, mobile apps may be most useful when integrated into structured care pathways with clear roles for monitoring, feedback, and follow-up. Future research should move beyond feature mapping to include evaluation of implementation, user engagement, cost transparency, and equity outcomes, particularly for long-term conditions such as DKD and CKD.