Patients’ and Nephrologists’ Evaluation of Patient-Facing Smartphone Apps for CKD

Abstract

Background and objectivesMany aspects of CKD management rely heavily on patient self-care, including medication and dietary adherence, self-monitoring of BP, and daily physical activity. Growing evidence suggests that incorporating smartphone-based applications can support self-care in CKD and chronic disease more generally.Design, setting, participants, & measurementsWe identified applications targeting patients with CKD by conducting a search of the US Apple App Store (iOS) and Google Play Store (Android) using the following four phrases: “kidney disease,” “renal,” “dialysis,” and “kidney transplant.” We considered the first 50 applications for each search term on each application store. We adapted a previously described framework for assessment of mobile health applications to account for kidney disease–specific content areas and evaluated applications on their types of patient engagement, quality, usability, and safety. Engagement and quality were assessed by both a patient and a nephrologist, usability was assessed by a patient, and safety was assessed by a nephrologist. Overall, two patients with CKD and three nephrologists performed the evaluations. We examined pairwise correlations between patient, nephrologist, and consumer ratings of application quality.ResultsOur search strategy identified 174 unique applications on Android and 165 unique applications on iOS. After excluding applications that were not related to kidney disease, were not patient facing, or were last updated before 2014, 12 Android-only applications, 11 iOS-only applications, and five dual-platform applications remained. Patient and nephrologist application quality ratings, assessed by the net promoter score, were not correlated (r=0.36; P=0.06). Consumer ratings on the application stores did not correlate with patient ratings of application quality (r=0.34; P=0.18).ConclusionsOnly a small subset of CKD applications was highly rated by both patients and nephrologists. Patients’ impressions of application quality are not directly linked to consumer application ratings or nephrologist impressions.

eHealth in kidney care

“…Importantly, patient ratings of app quality correlated poorly with provider ratings, highlighting the importance of incorporating patient input into eHealth solutions. The TAKE-IT trial assessed the efficacy of a multimodal intervention to promote medication adherence that incorporated patient input in the eHealth component 8 eHealth is gaining momentum in nephrology , although evidence for its efficacy remains unclear and challenges to its widespread adoption persist. Successful integration of eHealth into kidney care will require patient engagement to develop effective interventions and issues such as data validity , regulation, oversight and adequate infrastructure to be addressed.…”

“…All hardware and software tools must meet relevant security standards, and patients and care providers must be trained to use the equipment correctly and conduct the visits securely 5 . An ongoing extension of the TAKE-IT study, TAKE-IT TOO, aims to address the practical issues of incorporating the TAKE-IT intervention into routine clinical practice 8 . In addition, the NIDDK is developing a financial model to help health-care organizations plan investments in health information technology infrastructure to support CKD management (see Related links).…”

Epidemiology research to foster improvement in chronic kidney disease care

“…r e v i e w S Luo and ME Grams: Epidemiology research in kidney disease conduct of research studies, and the personalization of tools for CKD self-management such as smartphone applications. [112][113][114][115][116][117] Global initiatives are ongoing to reduce barriers to patient involvement in epidemiology research, such as patient uncertainty over their role in study design and guideline development and concerns from the academic community. 116,118,119 In Australia, the Standardized Outcomes in Nephrology initiative outlined practical steps to systematically implement consumer engagement in the management and research of kidney disease and to establish a set of core outcome measures on the basis of the shared priorities of patients, caregivers, clinicians, researchers, and policymakers.…”

Telemedizin 2.0 bei Heimdialyse

“…Im Rahmen von kleinen Feasibility-Studien wurde zumindest darauf hingewiesen, dass ein solcher Ansatz bei Ärzten und Patienten eine hohe Akzeptanz finden könnte [9]. Es bleibt zu hoffen, dass in Zukunft die Gruppe der chronisch nierenkranken Patienten allgemein sowie Dialysepatienten im Speziellen mehr in den Fokus von Industrie, Entwicklern und Kostenträgern rückt und dass bestehende App-Angebote für diese Patienten erweitert und weiterentwickelt werden [10]. Die Notwendigkeit weiterer Konkretisierungen für berufsrechtliches Vorgehen zum Datenschutz (StGb 203) zeigt sich am Beispiel der Erstkontaktaufnahme zwischen Arzt und Patient [11]: Eine irrtümliche Kontaktaufnahme an einen falschen Adressaten, z.…”