Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps

Lee, Ying-Li; Cui, Yan Yan; Tu, Ming; Chen, Yu-Ching; Chang, Polun

doi:10.2196/10173

Cited by 39 publications

(23 citation statements)

References 53 publications

(59 reference statements)

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“…In addition, the findings of this study are also consistent with those of a previous study [ 42 ] in which limited apps were found to be available for patient dietary self-management (8.7% vs 9.0%). Despite different evaluation aspects, we agreed with the study conducted by Lee et al [ 61 ], which found that commercial renal apps had limited capability to support renal patient self-management.…”

Section: Discussionsupporting

confidence: 89%

“…Prior studies had been conducted to evaluate commercial renal apps designed for both renal patients and health care professionals. These include studies pertaining to diet apps for general kidney diseases [ 14 ] and health apps specific to CKD management [ 42 , 61 ]. In comparison, this study was focused on diet apps designed specifically for dietary self-management in the dialysis population.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Lim¹,

Lim²,

Ibrahim³

et al. 2020

JMIR Mhealth Uhealth

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Background With the unprecedented growth of mobile technology, a plethora of dialysis diet apps have been developed to promote patient dietary self-management. Nevertheless, the utility of such apps remains questionable. Objective This study aimed to evaluate the content, features, and quality of commercial dialysis diet apps for adult dialysis patients. Methods This study consisted of a quantitative content analysis of commercial dialysis diet apps downloaded from Google Play and the Apple App Store available in the Asian marketplace, searched for using the following keywords in English: dialysis diet and diet for kidney disease. Free and paid apps available in English that provide nutrition information for adult dialysis patients were included. Apps that were not relevant to the dialysis diet, not meant for patient self-management, or redundant were excluded. Apps were evaluated for language medium (subscore=1), credibility (subscore=1), food database (subscore=1), valuable features (subscore=12), health-behavior theory constructs (subscore=60), and technical quality (subscore=25). The relationships among the variables of interest were determined by Pearson correlation. Stepwise multiple linear regression analysis was performed to identify the features that contribute to greater technical quality of dialysis diet apps. Statistical significance was defined as P<.05. Results A total of 22 out of 253 apps (8.7%) were eligible for evaluation. Based on a 100-point scale, the mean overall score of the apps was 31.30 (SD 14.28). Only 5% (1/22) of the apps offered relevant language options, and 46% (10/22) contained food databases. In addition, 54% (12/22) of the apps were not credible. The mean score for valuable features was 3.45 (SD 1.63) out of 12, in which general education (16/22, 73%), free download (15/22, 68%), and usability (13/22, 59%) were the three most popular features. However, the apps scored a mean of 13.41 (SD 11.56) out of 60 for health-behavior theory constructs. The overall app technical quality was considered poor, with a mean score of 2.70 (SD 0.41) out of 5. The scores of valuable features (r=.65, P=.001) and health-behavior theory constructs (r=.55, P=.009) were positively correlated with the overall technical quality of the commercial dialysis diet apps. Features such as free download (β=.43, P=.03) and usability (β=.41, P=.03) could significantly determine the functional quality of the apps. Health-behavior theory constructs such as self-monitoring could significantly predict both the subjective quality (β=.55, P=.008) and the engagement quality (β=.66, P=.001) of the apps, whereas the information quality domain could be determined by plan or orders (β=.48, P=.007) and knowledge (β=.45, P=.01). Conclusions Although most of the available commercial dialysis diet apps are free and easy to use, they are subject to theory deficiency, limited language options, and a lack of food databases, credibility, tailored education, and overall technical quality.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Lim¹,

Lim²,

Ibrahim³

et al. 2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…There are only few available apps that target patients with CKD specifically; however, most of them are available on app stores, and information on their efficacy and usability are rather scarce [ 41 ]. A recent content analysis of mobile apps for CKD revealed that available apps fail to provide the continuity of patient-centered care that is needed to support patients with CKD [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

A Dietary Mobile App for Patients Undergoing Hemodialysis: Prospective Pilot Study to Improve Dietary Intakes

Khoury¹,

Crutzen²,

Schols³

et al. 2020

J Med Internet Res

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Background Mobile technology has an impact on the health care sector, also within dietetics. Mobile health (mHealth) apps may be used for dietary assessment and self-monitoring, allowing for real-time reporting of food intakes. Changing eating behaviors is quite challenging, and patients undergoing hemodialysis, particularly, struggle to meet the target intakes set by dietary guidelines. Usage of mobile apps that are developed in a person-centered approach and in line with recommendations may support both patients and health care practitioners. Objective This study is a pilot that aims at estimating the potential efficacy of a dietary intervention using a theory-based, person-centered smartphone app. Results will be used to improve both the app and a planned large-scale trial intended to assess app efficacy thoroughly. Methods A prospective pilot study was performed at the hemodialysis unit of Al Qassimi Hospital (The Emirate of Sharjah). All patients that fulfilled the study inclusion criteria were considered eligible to be enrolled in the pilot study. Upon successful installation of the app, users met with a dietitian once a week. Outcomes were measured at baseline (T0) and 2 weeks post app usage (T1). This pilot is reported as per guidelines for nonrandomized pilot and feasibility studies and in line with the CONSORT 2010 checklist for reporting pilot or feasibility trials. Results A total of 23 patients completed the pilot intervention. Mean energy intakes increased from 24.4 kcal/kg/day (SD 8.0) to 29.1 kcal/kg/day (SD 7.8) with a medium effect size (d=0.6, 95% CI 0.0-1.2). Mean protein intakes increased from 0.9 g/kg/day (SD 0.3) to 1.3 g/kg/day (SD 0.5) with a large effect size (d=1.0, 95% CI 0.4-1.6); mean intake of high biological value (%HBV) proteins also increased from 58.6% (SD 10.1) to 70.1% (SD 10.7) with a large effect size (d=1.1, 95% CI 0.5-1.7). Dietary intakes of minerals did not change, apart from sodium which decreased from a mean intake of 2218.8 mg/day (SD 631.6) to 1895.3 mg/day (SD 581.0) with a medium effect size (d=0.5, 95% CI 0.1-1.1). Mean serum phosphorus, potassium, and albumin levels did not change relevantly. Mean serum iron increased from 7.9 mg/dL (SD 2.8) to 11.5 mg/dL (SD 7.9) postintervention with a medium effect size (d=0.6, 95% CI 0.0-1.2). Conclusions This pilot study showed that the KELA.AE app has the potential to improve dietary intakes. Processes related to procedure, resources, tools, and app improvement for a future trial were assessed. A more extended intervention using a randomized controlled trial is required to estimate parameters concerning app efficacy accurately.

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“…Of the 26 included articles, one reported a priori protocol registration 7 and four stated reporting was based on the PRISMA guideline for systematic reviews. 7,30,37,39 Adam 20 World of Urology Prostate Cancer Athilingam 21 JMIR Cardiology a Heart Failure Bhattarai 22 Pain Medicine Arthritic Pain Garcia-Cruz 23 Actas Urologicas Espanolas Men's sexual disorders Jupp 24 Pediatric Blood and cancer Cancer/Oncology Lee 25 JMIR mHealth and uHealth a Chronic Kidney Disease Luo 26 Journal of Clinical Rheumatology Rheumatoid Arthritis Rey 27 Neurologica Parkinson's Disease Svendsen 28 Journal of Dermatological Treatment Psoriasis Choi 29 Health Informatics Journal a Osteoarthritis Grainger 30 JMIR mHealth and uHealth a Rheumatoid Arthritis Martinez 31 JMIR Diabetes a Diabetes Rossi 32 mHealth a Diabetes Sobnath 33 JMIR mHealth and uHealth a Chronic Obstructive Pulmonary Disease Xie 34 JMIR mHealth and uHealth a Cardiovascular Disease Arnhold 35 JMIR a Diabetes Brouard 36 Annals of Medicine Cancer Brzan 37 Journal of Medical Systems a Diabetes Con 38 JMIR mHealth and uHealth a Inflammatory Bowel Disease Machado 7 Best Practice and Research Clinical Rheumatology Low back pain Fijacko 39 Journal of Medical Systems a Type 2 Diabetes Lee 40 British Journal of Sports Medicine Concussion Wurzer 41 Burns Burns Vega 42 PLOS One Pain Wallace 43 Journal of Opioid Management Chronic Pain El-Gayar 44 Journal of Diabetes Science and Technology Diabetes a Journals listed in field of 'Medical Informatics' in InCites Journal Citation Reports (Clarivate Analytics, 45 or published in subsidiary journal of JMIR.…”

Section: A Priori Review Registration and Registration Guidelinementioning

confidence: 99%

Issues in reporting of systematic review methods in health app-focused reviews: A scoping review

Grainger

Devan

Sangelaji³

et al. 2020

Health Informatics J

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No guidelines exist for the conduct and reporting of manuscripts with systematic searches of app stores for, and then appraisal of, mobile health apps (‘health app-focused reviews’). We undertook a scoping review including a systematic literature search for health app-focused reviews describing systematic app store searches and app appraisal, for apps designed for patients or clinicians. We created a data extraction template which adapted data elements from the PRISMA guidelines for systematic literature reviews to data elements operationalised for health app-focused reviews. We extracted the data from included health app-focused reviews to describe: (1) which elements of the adapted ‘usual’ methods of systematic review are used; (2) methods of app appraisal; and (3) reporting of clinical efficacy and recommendations for app use. From 2798 records, the 26 included health app-focused reviews showed incomplete or unclear reporting of review protocol registration; use of reporting guidelines; processes of screening apps; data extraction; and appraisal tools. Reporting of clinical efficacy of apps or recommendations for app use were infrequent. The reporting of methods in health app-focused reviews is variable and could be improved by developing a consensus reporting standard for health app-focused reviews.

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Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps

Cited by 39 publications

References 53 publications

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: Quantitative Content Analysis Study

A Dietary Mobile App for Patients Undergoing Hemodialysis: Prospective Pilot Study to Improve Dietary Intakes

Issues in reporting of systematic review methods in health app-focused reviews: A scoping review

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