Preferences of people with chronic kidney disease regarding digital health interventions that promote healthy lifestyle: qualitative systematic review with meta-ethnography

Abstract

ObjectivesDiet and physical activity are crucial for people with chronic kidney disease (CKD) to maintain good health. Digital health interventions can increase access to lifestyle services. However, consumers’ perspectives are unclear, which may reduce the capacity to develop interventions that align with specific needs and preferences. Therefore, this review aims to synthesise the preferences of people with CKD regarding digital health interventions that promote healthy lifestyle.DesignQualitative systematic review with meta-ethnography.Data sourcesDatabases Scopus, CENTRAL, MEDLINE, CINAHL and SPORTDiscus were searched between 2000 and 2023.Eligibility criteriaPrimary research papers that used qualitative exploration methods to explore the preferences of adults with CKD (≥18 years) regarding digital health interventions that promoted diet, physical activity or a combination of these health behaviours.Data extraction and synthesisTwo independent reviewers screened title, abstract and full text. Discrepancies were resolved by a third reviewer. Consumers’ quotes were extracted verbatim and synthesised into higher-order themes and subthemes.ResultsDatabase search yielded 5761 records. One record was identified following communication with a primary author. 15 papers were included. These papers comprised 197 consumers (mean age 51.0±7.2), including 83 people with CKD 1–5; 61 kidney transplant recipients; 53 people on dialysis. Sex was reported in 182 people, including 53% male. Five themes were generated regarding consumers’ preferences for digital lifestyle interventions. These included simple instruction and engaging design; individualised interventions; virtual communities of care; education and action plans; and timely reminders and automated behavioural monitoring.ConclusionDigital health interventions were considered an important mechanism to access lifestyle services. Consumers’ preferences are important to ensure future interventions are tailored to specific needs and goals. Future research may consider applying the conceptual framework of consumers’ preferences in this review to develop and evaluate the effect of a digital lifestyle intervention on health outcomes.PROSPERO registration numberCRD42023411511.

Digital Physical Activity and Exercise Interventions for People Living with Chronic Kidney Disease: A Systematic Review of Health Outcomes and Feasibility

“…While the findings of this review demonstrate the current evidence-base is limited, fourteen registered trials were identified, including 12 RCTs (combined target sample size ~ 3,000 participants) [ 45 – 51 , 61 , 62 , 75 – 77 ].This suggests that the evidence base will soon increase substantially, providing further insight into efficacy, though only where consumer preferences are met [ 78 ]. People living with CKD are interested in digital interventions to manage their condition [ 79 , 80 ], but frequently report a lack of specific advice [ 81 , 82 ].…”

“…Well-rounded digital interventions are likely to address this important gap. A recent systematic review identified key features to support consumer needs in digital exercise interventions including supporting virtual communities of care, specific education, reminders/monitoring and crucially, the ability to individualise exercise programs [ 78 ]. There were also several studies whose primary outcomes were outside the scope of this review e.g., primary focus on diet or medication with digital support, or activity trackers only without physical activity promotion components.…”