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In the evolving landscape of chronic disease management, remote patient monitoring (RPM) has emerged as a pivotal tool, particularly for patients with chronic kidney disease (CKD) and those undergoing peritoneal dialysis (PD). The study aims to evaluate the acceptance and usability of a newly developed RPM mobile application (App) designed to track vital signs, dietary habits, medication adherence, and dialysis data.
This study enrolled CKD and PD patients to use an RPM App for 6-months. Conducted at a single centre in Singapore, participant enrolment took place from May 2022 to August 2022. The primary objective was to examine the acceptance and usability of the App. Acceptance rate was defined as the proportion of patients using the App at least once daily for PD patients and twice weekly for CKD patients. Days when the App was used at least once were considered “active days”. The Technology Readiness Index (TRI) of participants was assessed and presented in its 5 categories (Figure 1). The number of unplanned clinic or hospital visits before (6 months) and during the study (6 months) were compared. Bluetooth-enabled smart devices were provided to the participants for vital signs monitoring (blood pressure, heart rate, pulse oximetry, body temperature, body weight). Midway through the study, usability of the App was assessed by administering mHealth App Usability Questionnaire (MAUQ). The MAUQ is a validated questionnaire consisting of 3 subscales utilising a Likert scale of 1 (strongly disagree) to 7 (strongly agree).
35 participants were enrolled (22 PD, 13 CKD) with a median age of 55 (47-67) years; 63% were female. The TRI findings revealed that 40% of participants fell into the 'Skeptic’ category (Figure 1). Among the 35 participants, 27 (PD=19, CKD=8) completed the 6-month study. They had an acceptance rate of approximately 56% (PD= 47.3%, CKD = 75%). On active days CKD patients spent about 7.5 minutes while PD patients spent 12.5 minutes per day. Smart devices for vital signs recording were used on 98% of the total active days. The acceptance rates for both males (55.6%) and females (55.6%) participants were comparable (p=1.0). There were no age group differences; those under 65 years and ≥ 65 years had a similar acceptance rate. There were significant differences in the usability assessment (MAUQ scores) between the CKD and PD participants (Table 1). A decrease in unplanned clinic/hospital visits or admissions related to CKD/PD issues was observed, however, this sample size was too small to calculate statistical significance (Table 2).
Conclusions
This study attempted to assess level of acceptance for the RPM App. PD patients may have shown a lower usage and given a lower usability scoring compared to CKD patients as they had to continue recording their PD treatment information in PD diaries in addition to recording it via the App. These results highlight the potential of RPM technologies in chronic disease management, also underscoring the need for tailored approaches to different patient groups. This study paves the way for the continuous evolution of patient-centred digital health solutions, with the ultimate goal of enhancing patient care and self-management in kidney disease.