CKD Patients Feel More Confident With Smartphone Self-Management

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High user adherence; statistically significant reduction in BP readings with use of app
High user adherence; statistically significant reduction in BP readings with use of app

HealthDay News — A smartphone-based self-management system is feasible for patients with advanced chronic kidney disease (CKD), according to a study published online May 12 in the Clinical Journal of the American Society of Nephrology.

Stephanie W. Ong, from the University Health Network in Toronto, and colleagues developed a smartphone-based system to boost self-care by patients with CKD. The application targeted 4 behavioral elements: blood pressure (BP), medication management, symptom assessment, and tracking laboratory results. When predefined treatment thresholds were crossed or critical changes occurred, real-time personalized patient feedback and alerts were provided. Changes in clinical measures were assessed for 47 patients with stage 4 and 5 CKD who were followed for 6 months after recruitment.

The researchers found that user adherence was high and sustained, with more than 80% of participants performing at least 80% of recommended assessments. Significant reductions were seen between baseline and exit in home BP readings (systolic BP, −3.4 mm Hg; diastolic BP, −2.1 mm Hg). Masked hypertension was newly identified in 27% of those with normal clinic BP readings. The researchers identified 127 medication discrepancies, 59% of which required an intervention to prevent harm. Patients indicated feeling more confident and in control of their condition in exit interviews.

"Integrating a smartphone-based self-management system into usual care of patients with advanced CKD proved feasible and acceptable and appeared to be clinically useful," the authors write.

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