Features and Effects of Information Technology-Based Interventions to Improve Self-Management in Chronic Kidney Disease Patients: a Systematic Review of the Literature

Abstract

Slowing down the progression of chronic kidney disease (CKD) and its adverse health outcomes requires the patient's self-management and attention to treatment recommendations. Information technology (IT)-based interventions are increasingly being used to support self-management in patients with chronic diseases such as CKD. We conducted a systematic review of randomized controlled trials (RCTs) to assess the features and effects of IT-based interventions on self-management outcomes of CKD patients. A comprehensive search was conducted in Medline, Scopus, and the Cochrane Library to identify relevant papers that were published until May 2016. RCT Studies that assessed at least one automated IT tool in patients with CKD stages 1 to 5, and reported at least one self-management outcome were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment tool. Out of 12,215 papers retrieved, eight study met the inclusion criteria. Interventions were delivered via smartphones/personal digital assistants (PDAs) (three studies), wearable devices (three studies), computerized systems (one study), and multiple component (one study). The studies assessed 15 outcomes, including eight clinical outcomes and seven process of care outcomes. In 12 (80%) of the 15 outcomes, the studies had revealed the effects of the interventions as statistically significant positive. These positive effects were observed in 75% of the clinical outcomes and 86% of the process of care outcomes. The evidence indicates the potential of IT-based interventions (i.e. smartphones/PDAs, wearable devices, and computerized systems) in self-management outcomes (clinical and process of care outcomes) of CKD patients.

Integrated Model of Care for Polycystic Ovary Syndrome

“…Recently, information technology-based interventions or digital health interventions (e.g., e-health and m-health) have been shown to be beneficial in the self-management of chronic diseases and obesity prevention, although their application remains to be determined in PCOS. 20,28,31,32…”

<p>Enhancement of Adherence to Therapeutic and Lifestyle Recommendations Among Hemodialysis Patients: An Umbrella Review of Interventional Strategies</p>

“…The range of interventions that had been reported in this group of systematic reviews to boost therapeutic and lifestyle recommendations adherence in the hemodialysis patients included psycho-educational (in 8 publications), 6,20-26 physical activity enhancement (in 2 systematic reviews 27,28 with recommended home and HD center-based aerobic, resistance and low-intensity strength training before or during HD sessions, home-based cycling and walking, stretching, Hatha yoga exercise in the included studies of the systematic review conducted by Barcellos et al 27 and intradialytic exercise training in the systematic review of the Gomes Neto et al), 28 IT platformbased intervention (in 2 studies) 29,30 and aromatherapy in another systematic review study. 31 None of the included publications had all the 11 quality criteria of the JBI…”

The “Mikidney” smartphone app pilot study: Empowering patients with Chronic Kidney Disease

“…mHealth apps are increasingly being used to promote selfmanagement of chronic illness such as chronic obstructive pulmonary disease (McCabe et al 2017), asthma (Marcano Belisario et al 2013, cardiac disease (Widmer et al 2017) and diabetes (Plotnikoff et al 2017). This is not apparent within the CKD patient population (Diamantidis & Becker 2014) as seen in a systematic review (Jeddi et al 2017) investigating features and effects of information technology-based interventions on self-management outcomes in CKD. Of the eight studies meeting the inclusion criteria only one (Sevick et al 2016) investigated the use of an mHealth app.…”

“…This is not apparent within the CKD patient population (Diamantidis & Becker ) as seen in a systematic review (Jeddi et al . ) investigating features and effects of information technology‐based interventions on self‐management outcomes in CKD. Of the eight studies meeting the inclusion criteria only one (Sevick et al .…”