Digital Health Technology Adoption among Older Nigerian Adults with Type 2 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study

Abstract Background: Digital health technologies are increasingly utilized in chronic disease management; however, limited data exist on their adoption among older adults with type 2 diabetes mellitus (T2DM) in sub-Saharan Africa. Understanding usage patterns and predictors is essential for equitable healthcare delivery. Objectives: The objectives of the study was to assess the prevalence, patterns, and determinants of digital health tool usage among older Nigerian adults with T2DM across tertiary healthcare settings. Materials and Methods: A hospital-based cross-sectional study was conducted from November 2023 to May 2025 across 13 purposely selected tertiary hospitals spanning Nigeria’s six geopolitical zones and the Federal Capital Territory. A total of 398 adults aged ≥60 years with confirmed T2DM were surveyed using the validated digital health tool use for diabetes care assessment questionnaire. Descriptive statistics summarized usage patterns. Chi-square tests and odds ratios (OR) were used to examine associations between digital tool use and sociodemographic or clinical variables ( P ≤ 0.05). Results: Overall, 76.9% of participants used at least one digital health tool. Common tools included medication reminder apps (90.8%), dietary trackers (87.3%), and wearables (79.1%). Significant predictors of digital health tool usage included being male (female gender was associated with lower odds of use: OR = 0.27; P = 0.014), diabetes duration ≥5 years (OR = 4.02; P = 0.021), cardiovascular complications (OR = 5.23; P = 0.011), and age ≥70 years, which was associated with the higher usage compared to the 60–69 age group ( P = 0.013). Key barriers included cost (89.2%) and limited technical support (94.4%). Conclusion: Older Nigerian adults with T2DM show high digital health engagement. Policy interventions must address persistent systemic barriers to foster inclusive digital self-management.