Effectiveness of a Mobile Health (mHealth) Intervention on the Prevention of Chronic Kidney Disease in Older Adults: A Randomized Controlled Trial in Vietnam

 

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Effectiveness of a Mobile Health (mHealth) Intervention on the Prevention of Chronic Kidney Disease in Older Adults: A Randomized Controlled Trial in Vietnam

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Minh
Nguyen-Thien
Tung Thanh Phan minh.nguyen.juan@gmail.com Vinh Loc, Ho Chi Minh city Vinh Loc Health station Ho Chi Minh city Vietnam -
Minh Nguyen-Thien minhnt@ump.edu.vn University of Medicine and Pharmacy at Ho Chi Minh City Epidemiology Ho Chi Minh city Vietnam *
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The rising prevalence of Chronic Kidney Disease (CKD) among aging populations poses a significant public health challenge. This study aimed to evaluate the effectiveness of a mobile health (mHealth) intervention on the one-year incidence of CKD and the rate of eGFR decline among older adults in Vietnam.

In this randomized controlled trial, 702 community-dwelling adults aged ≥60 years with an eGFR ≥60 mL/min/1.73m² were recruited and randomly assigned (1:1) to an intervention (n=351) or a control group (n=351). The intervention group received a 12-month mHealth program featuring weekly educational messages and monthly coaching calls. The control group received standard educational pamphlets. The primary outcome was incident CKD (eGFR <60 mL/min/1.73m², confirmed after ≥90 days). A key secondary outcome was the mean annual change in eGFR. Outcome assessors were blinded to group allocation. Analyses were performed on an intention-to-treat basis.

Baseline characteristics were well-balanced; mean age was 67.4 (SD 5.2) years. The incidence of new-onset CKD was 8.5% (30/351) in the intervention group versus 11.1% (39/351) in the control group. The mHealth intervention reduced the risk of new-onset CKD (HR = 0.76, 95% CI: 0.59-0.97, p = 0.03). Furthermore, the intervention group experienced a significantly slower mean annual decline in eGFR compared to the control group (-1.2 vs. -2.1 mL/min/1.73m²; mean difference, 0.9; p = 0.04). A pre-specified interaction analysis showed the intervention's benefit on the primary outcome was concentrated among participants without type 2 diabetes (T2D) (p-interaction = 0.02), while a significant effect was not demonstrated among those with T2D (HR = 0.94, 95% CI: 0.67-1.32).

A 12-month mHealth intervention resulted in a lower incidence of new-onset CKD and a slower rate of eGFR decline among older adults. While the benefit for CKD incidence was not demonstrated in the subgroup with T2D, possibly due to limited statistical power, mHealth remains a promising preventative strategy. More intensive interventions may be required for high-risk diabetic populations.

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