SP840A NEW APP FOR HELPING PATIENTS WITH CHRONIC KIDNEY DISEASE IN DIALYSIS AND AFTER TRANSPLANTION

Abstract

INTRODUCTION AND AIMS: The aim of this study is to present a new app for smartphones to help patients with chronic kidney disease (CKD) in dialysis and after transplantation. METHODS: Semi-structured interviews were done with individuals not on treatment for CKD and individuals with CKD (in hemodialysis and transplanted patients), aiming to know their main doubts about CKD and difficulties in adhering treatment. Based on the responses of this phase we have developed an application for smartphones, which we have called “Renal Health”, and then conducted a test with patients (usability test) and healthcare workers experts in Nephrology (validation test). RESULTS: A total of 30 individuals of the general population (without CKD) were interviewed; 60% of them said that would like to have more information about CKD, as well as how to prevent it. Among patients in hemodialysis (n=26), 53.8% said to have difficulties in controlling medications, half of them reported difficulties in following dietary prescriptions, and 56.7% said not to have problems for water intake control. Half of these patients reported the need of having more information about diet and 23% about other treatment modalities and kidney transplantation. All transplanted patients (n=7) said not to have difficulties in going to medical consultations, and the majority of them (57.1%) said not to have problem in taking immunosuppressant drugs. Regarding advices they would like to have, the majority of them reported nutritional advices. Based on these needs we have developed the “Renal Health” application, with several functionalities for patients with CKD, in dialysis and kidney transplant. In the usability test, with 10 patients in hemodialysis, the main suggestions were to improve font size, graphic description and inclusion of more contents about nutrition. The test with specialists, which was done with 2 physicians, 2 nurses, 1 psychologist and 1 nutritionist, evidenced an acceptability of 89.6%. The items with lowest scores were related to language suitability (to improve patients' comprehension) and adjustment in font size. Figure 1 shows some screens of the app (initial screen, water intake control, weight control, laboratory tests follow-up). CONCLUSIONS: There are many doubts about CKD by both general population and CKD patients, which can be clarified through the “Renal Health” application. The application was well evaluated by patients and healthcare workers, and it can be an important tool for increasing patients' adherence to treatment, increasing general population knowledge about CKD and its' preventive measures. It can also be an important tool to help controlling CKD complications, such as fluid overload (in dialysis patients) and allograft rejection (in transplanted patients). It is also possible that improving patients' adherence to treatment may decrease mortality in the context of CKD. The next step in this research will be to test the app among patients in dialysis and after transplantation, in a longitudinal study, and investigate if its use is associated with decrease in clinical complications.