OUTCOMES OF MODIFIED M-HEALTH INSTRUCTIONS FOR SELF-CARE AFTER RENAL TRANSPLANTATION

Introduction:

Kidney transplant is preferred over lifelong dialysis for End-Stage Kidney Disease (ESKD) due to better quality of life. However, improper self-management can reduce this benefit. Comprehensive education on post-transplant self-care is crucial for improving the outcomes. 

Methods:

A

At our centre, written instructions at the time of discharge were being used to guide kidney transplant recipients at discharge from the hospital. A quasi-experimental research design was used in the present study, which was conducted in three phases. In the first phase, the data was collected from the old patients visiting Renal Transplant OPD as well as from the nurses working in Renal Transplant Surgery Unit to assess the limitations of existing ‘discharge instructions’ and suggest solutions. In the second phase, a 'Modified m-health discharge instruction module' was developed based on a review of the literature, expert consultations and an analysis of the findings from the first phase. This module consisted of a 36-page booklet (Figure 1) in comparison to the 1-page (Figure 2) limited instruction set that was being used. Additionally, audio-visual material demonstrating care were made part of this module. In the third phase, 40 patients were enrolled, 20 each in the experimental and control groups. Patients in the experimental group were given the 'Modified m-health discharge instruction module,' while the control group received the prevailing routine care. Dedicated mobile number for contact through messaging platform was provided to patients of both the groups for posting their queries and get solutions to reduce the number of hospital visits. Queries raised by patients on this messaging platform were recorded. Participants were requested to report feedback on various aspects of care at the end of 3 months. Likert scale was used to record the nurses’ perspectives on the usability of the 'Modified m-health discharge instruction module'. The trial was registered at clinical trials registry of India (CTRI/2020/07/026578).

Results:

The 'Modified m-health discharge instruction module' was developed and implemented on pilot basis. 40 participants were enrolled. 39 participants (control: 20, experimental: 19) completed the study. A total of 387 queries were raised in the experimental group, while 607 queries were recorded in the control group (Table 1).  More than 90% patients in experimental group were satisfied with the instructions and information on parameters like blood pressure monitoring, fluid intake and output monitoring, infection and minor ailments. 25% patients in control group were dissatisfied with the information provided at the time of discharge (Table 2). All 15 nurses (100%) agreed that the 'Modified m-health discharge instruction module' was adequate, easy to understand yet exhaustive as compared to the existing 1-page discharge advice (Table 3).

Conclusions:

The ‘Modified m-health discharge instruction module’ was effective in boosting patient’s satisfaction in managing themselves at home, resulting in fewer queries. This sets the stage for testing the impact of such interventions on long term outcomes in this population.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.