Feasibility Study of a Smartphone App and Web Portal for Remote Monitoring of Chronic Kidney Disease and Peritoneal Dialysis Populations: A Mixed-Method Study.

INTRODUCTION

Remote patient monitoring facilitates the management of chronic conditions like chronic kidney disease (CKD) and home-based peritoneal dialysis (PD). This study assessed the acceptance of a remote monitoring application in CKD and PD patients.

METHODS

It was a single-center study at Singapore General Hospital from December 2021 to February 2023, recruiting CKD and PD patients. Patients were followed up for up to 6 months. The Viva Konnect patient app allowed users to record vitals with a Bluetooth-enabled device, log medication schedule, track symptoms, log diet, and monitor PD therapy.

RESULTS

A total of 35 participants (13 CKD, 22 PD) enrolled; 8 (5 CKD, 3 PD) dropped out, leaving 27 (8 CKD, 19 PD) who completed the study. Among those who completed the study, 56% met the app acceptance criteria - defined as CKD patients logging data at least twice per week and PD patients at least once daily. Acceptance rates were 47.4% for PD and 75.0% for CKD. PD patients used the app a median of 6.7 (IQR: 1.8-16.5) times per week, spending 6.9 (IQR: 2.2-12.1) minutes per session. CKD patients used it a median of 6.2 (IQR: 2.6-6.7) times per week, with a median session time of 4.7 (IQR: 1.7-7.7) minutes. The median percentage of vitals recorded via smart companion devices was 52.9% (IQR: 26.7-82.2) for PD patients and 83.4% (IQR: 78.8-94.4) for CKD patients. Interviews identified three key themes that affected the usage: communication, convenience, and clarity.

CONCLUSION

Overall app usage was moderate, with the CKD patient population showing better app acceptance than the PD population. To improve the usage and overall engagement, future app development should incorporate two-way communication with clinicians, a reduced burden of data recording, and better integration into established clinical workflows.