Smartphone and application use in self-management of chronic kidney disease

a cross-sectional feasibility study

Authors

Keywords:

Renal insufficiency, chronic, Treatment adherence and compliance, Smartphone, Self-management, Dialysis

Abstract

INTRODUCTION: Smartphone and application use can improve communication and monitoring of chronic diseases, including chronic kidney disease, through self-management and increased adherence to treatment. OBJECTIVE: To assess smartphone use in patients with chronic kidney disease on dialysis and their willingness to use mobile applications as a disease self-management strategy. DESIGN AND SETTING: This was a cross-sectional study of chronic kidney disease patients on hemodialysis in the São Francisco Valley in the Northeast Region, Brazil. METHODS: The questionnaire developed by the authors was administered between April and June 2021. Cronbach’s alpha coefficient for the construct was 0.69. Associations between the dependent and independent variables were determined using univariate analysis. Multivariate analysis with logistic regression analysis was also performed. RESULTS: A total of 381 patients were included, of whom 64% had a smartphone, although only 3.1% knew of a kidney disease-related application. However, 59.3% believed that using an application could help them manage their disease. Having a smartphone was associated with treatment adherence, higher educational attainment, and higher per capita income. Educational attainment remained an independent factor in multivariate analysis. CONCLUSION: More than 64% of patients had a smartphone, although few knew of applications developed for kidney disease. More than half of the population believed that technology use could benefit chronic kidney disease treatment. Smartphone ownership was more common among the younger population, with higher educational attainment and income, and was associated with greater adherence to hemodialysis sessions.

Downloads

Download data is not yet available.

Author Biographies

Christielle Lidianne Alencar Marinho, Universidade de Pernambuco

MSc. Nurse and Doctoral Student, Health Sciences Program, Universidade de Pernambuco (UPE), Recife (PE), Brazil.

Orlando Vieira Gomes, Universidade de Pernambuco

MD, MSc. Nephrologist and Assistant Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Geraldo Bezerra da Silva Junior, Universidade de Pernambuco

MD, PhD. Physician and Professor, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará (UFC), and School of Medicine, Public Health and Medical Sciences Graduate Programs, Universidade de Fortaleza (UNIFOR), Fortaleza (CE), Brazil.

Paulo Adriano Schwingel, Universidade de Pernambuco

PhD. Sports Physiologist and Associate Professor, Human Performance Research Laboratory, Universidade de Pernambuco (UPE), Petrolina (PE), Brazil.

References

Levin A, Tonelli M, Bonventre J, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;21;390(10105):1888-1917. PMID: 28434650; https://doi.org/10.1016/S0140-6736(17)30788-2.

Crews DC, Bello AK, Saadi G. 2019 World Kidney Day Editorial - burden, access, and disparities in kidney disease. J Bras Nefrol. 2019;41(1):1-9. PMID: 31063178; https://doi.org/10.1590/2175-8239-JBN-2018-0224.

Jonsson AJ, Lund SH, Eriksen BO, Palsson R, Indridason OS. The prevalence of chronic kidney disease in Iceland according to KDIGO criteria and age-adapted estimated glomerular filtration rate thresholds. Kidney Int. 2020;98(5):1286-95. PMID: 32622831; https://doi.org/10.1016/j. kint.2020.06.017.

Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020;16(10):573-85. PMID: 32733095; https://doi.org/10.1038/s41581-020-0315-4.

Assis Buosi AP, Paturkar D, Dias ER, et al. The Rights of Patients with Chronic Kidney Disease in the World: Legal Perspectives and Challenges in Brazil, India, Portugal, South Africa, and Nigeria. Contrib Nephrol. 2021;199:322-38. PMID: 34344007; https://doi.org/10.1159/000517722.

Neves PDMM, Sesso RCC, Thomé FS, Lugon JR, Nascimento MM. Inquérito Brasileiro de Diálise Crônica 2019. Braz J Nephrol. 2021;43(2):217-27. https://doi.org/10.1590/2175-8239-JBN-2020-0161.

Acar D, Güneş Z. Factors affecting therapeutic compliance in patients with chronic renal failure: Anxiety, Depression, Illness Perception. Health Prim Care. 2018;2(3):1-6. https://doi.org/10.15761/HPC.1000137.

Chan CT, Blankestijn PJ, Dember LM, et al. Dialysis initiation, modality choice, access, and prescription: conclusions from a kidney disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019;96(1):37-47. PMID: 30987837; https://doi.org/10.1016/j.kint.2019.01.017.

International Telecommunication Union. ITU Statistics Retrieved from. 2021. Available from: https://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx. Accessed in 2022 (Apr 28).

Osei E, Mashamba-Thompson TP. Mobile health applications for disease screening and treatment support in low-and middle-income countries: A narrative review. Heliyon. 2021;7(3):e06639. PMID: 33869857; https://doi.org/10.1016/j.heliyon.2021.e06639.

Harding K, Biks GA, Adefris M, et al. A mobile health model supporting Ethiopia’s eHealth strategy. Digit Med. 2018;4(2):54-65. PMID: 31608321; https://doi.org/10.4103/digm.digm_10_18.

Jemere AT, Yeneneh YE, Tilahun B, et al. Access to mobile phone and willingness to receive mHealth services among patients with diabetes in Northwest Ethiopia: a cross-sectional study. BMJ Open. 2019;9(1):e021766. PMID: 30679284; https://doi.org/10.1136/bmjopen-2018-021766.

Abolfotouh MA, BaniMustafa A, Salam M, et al. Use of smartphone and perception towards the usefulness and practicality of its medical applications among healthcare workers in Saudi Arabia. BMC Health Serv Res. 2019;19(1):826. PMID: 31718639; https://doi.org/10.1186/s12913-019-4523-1.

Kruse C, Betancourt J, Ortiz S, et al. Barriers to the Use of Mobile Health in Improving Health Outcomes in Developing Countries: Systematic Review. J Med Internet Res. 2019;21(10):e13263. PMID: 31593543; https://doi.org/10.2196/13263.

Cedillo-Couvert EA, Ricardo AC, Chen J, et al. CRIC Study Investigators. Self-reported Medication Adherence and CKD Progression. Kidney Int Rep. 2018;3(3):645-51. PMID: 29854972; https://doi.org/10.1016/j.ekir.2018.01.007.

GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33. PMID: 32061315; https://doi.org/10.1016/S0140-6736(20)30045-3.

Andrade AS, Lima JS, Inagaki AD, et al. Fatores associados à qualidade de vida de pacientes submetidos à hemodiálise. Enferm Foco. 2021;12(1):20-5. https://doi.org/10.21675/2357-707X.2021.v12.n1.3451.

Jonsson AJ, Lund SH, Eriksen BO, Palsson R, Indridason OS. The prevalence of chronic kidney disease in Iceland according to KDIGO criteria and age-adapted estimated glomerular filtration rate thresholds. Kidney Int. 2020;98(5):1286-95. PMID: 32622831; https://doi.org/10.1016/j.kint.2020.06.017.

Senanayake S, Gunawardena N, Palihawadana P, et al. Health related quality of life in chronic kidney disease; a descriptive study in a rural Sri Lankan community affected by chronic kidney disease. Health Qual Life Outcomes. 2020;18(1):106. PMID: 32326945; https://doi.org/10.1186/s12955-020-01369-1.

Gesualdo GD, Duarte JG, Zazzetta MS, Kusumota L, Orlandi FS. Fragilidade e fatores de risco associados em pacientes com doença renal crônica em hemodiálise. Cien Saude Coletiva. 2020;25(11):4631-37 https://doi.org/10.1590/1413-812320202511.03482019.

Amaral TLM, Amaral CA, Vasconcellos MTL, Monteiro GTR. Doença renal crônica em adultos de Rio Branco, Acre: inquérito de base populacional [Chronic kidney disease among adults in Rio Branco, State of Acre: a population-based survey]. Cien Saude Coletiva. 2021;26(1):339-50. https://doi.org/10.1590/1413-81232020261.22402018.

Mariani AW, Pêgo-Fernandes PM. The impact of COVID-19 on the development and consolidation of telemedicine. Sao Paulo Med. J. 2021;139(3):199-200. PMID: 33978134; https://doi.org/10.1590/1516-3180.2021.139305042021.

Hussein WF, Bennett PN, Pace S, et al. The Mobile Health Readiness of People Receiving In-Center Hemodialysis and Home Dialysis. Clin J Am Soc Nephrol. 2020;16(1):98-106. PMID: 33355235; https://doi.org/10.2215/CJN.11690720.

Bonner A, Gillespie K, Campbell KL, et al. Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study. BMC Nephrol. 2018;19(1):28. PMID: 29394930; https://doi.org/10.1186/s12882-018-0830-8.

Byambasuren O, Beller E, Glasziou P. Current Knowledge and Adoption of Mobile Health Apps Among Australian General Practitioners: Survey Study. JMIR Mhealth Uhealth. 2019;7(6):e13199. PMID: 31199343; https://doi.org/10.2196/13199.

da Silva Junior GB, de Oliveira JGR, de Araújo EMR, et al. Renal Health: Providing Information and Technological Tools to Empower Patients to Live Better with Kidney Disease. Stud Health Technol Inform. 2021;281:674-8. PMID: 34042661; https://doi.org/10.3233/SHTI210257.

Ma Q, Chan AH, Chen K. Personal and other factors affecting acceptance of smartphone technology by older Chinese adults. Appl Ergon. 2016;54:62-71. PMID: 26851465; https://doi.org/10.1016/j.apergo.2015.11.015.

Sayed MI, Mamun-Ur-Rashid M. Factors influencing e-Health service in regional Bangladesh. Int J Health Sci (Qassim). 2021;15(3):12-9. PMID: 34234631.

Oliveira JGR, Askari M, Fahd MGN, et al. Chronic Kidney Disease and the Use of Social Media as Strategy for Health Education in Brazil. Stud Health Technol Inform. 2019;264:1945-6. PMID: 31438420; https://doi.org/10.3233/SHTI190726.

Sousa H, Ribeiro O, Paúl C, et al. Social support and treatment adherence in patients with end-stage renal disease: A systematic review. Semin Dial. 2019;32(6):562-74. PMID: 31309612; https://doi.org/10.1111/sdi.12831.

Chan AHY, Honey MLL. User perceptions of mobile digital apps for mental health: Acceptability and usability - An integrative review. J Psychiatr Ment Health Nurs. 2022;29(1):147-68. PMID: 33604946; https://doi.org/10.1111/jpm.12744.

Ernsting C, Dombrowski S, Oedekoven M, et al. Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey. J Med Internet Res. 2017;19(4):e101. PMID: 28381394; https://doi.org/10.2196/jmir.6838.

Downloads

Published

2023-06-27

How to Cite

1.
Marinho CLA, Gomes OV, Silva Junior GB da, Schwingel PA. Smartphone and application use in self-management of chronic kidney disease: a cross-sectional feasibility study. Sao Paulo Med J [Internet]. 2023 Jun. 27 [cited 2025 Mar. 14];141(4):1-8. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/491

Issue

Section

Original Article