Charlotte Robinson

DocwireNews

Support programs for disease self-management are underutilized among patients with chronic kidney disease. A team of researchers led by Sarah J. Schrauben, MD, examined the feasibility of implementing a smartphone support tool for individuals with both CKD and hypertension. The tool, Supporting Self-Management of Healthy Behaviors (SMART-HABITS), could be used for self-monitoring physical activity and blood pressure (BP). Study results appeared in the Clinical Journal of the American Society of Nephrology.The randomized SMART-HABITS trial took place over 12 weeks and included adults with CKD and hypertension. Study participants were requested to monitor their BP three or more times per week and their step counts five or more times per week.The participants were randomized to BP communication approach, either self-reporting by text message for 6 weeks or reporting automatically using a smartphone application paired with a Bluetooth-enabled BP machine for the alternate 6 weeks. The approach to monitoring and reporting steps was the same for both phases.The primary study outcomes included adoption (retention and use of the SMART-HABITS dashboard), adherence (the percentage of transmitted BP readings and step counts), and acceptability. These outcomes were evaluated using surveys and interviews. The secondary outcomes included reach, maintenance, CKD knowledge, digital health literacy, self-management, self-efficacy, quality of life, step counts, and BP values. Interviews occurred at the end of the study period.There were 47 randomized participants in the study. Of them, 49% were female and 45% were Black. The median participant age was 63 years. Forty-four participants (94%) completed the text phase, while 43 (92%) completed the application phase.Adoption was 91%, acceptability scores were high, and the interviewees generally communicated acceptance. BP adherence was 87% in the text phase and 74% in the app phase. Step count adherence was 97%. Mean step counts increased similarly from the prestudy period in both the text and app phases. BP showed no change over time. Lastly, CKD knowledge increased, but the remaining survey scores were unchanged.In sum, it was feasible to implement the SMART-HABITS tool among patients with CKD and hypertension despite low digital health literacy. The tool was found to have high levels of adherence and usability scores. This approach could enhance clinic-based care and reduce cardiovascular disease and CKD progression.Source: <a href="https://doi.org/10.2215/CJN.0000000000000492" target="_blank" rel="noopener">Clinical Journal of the American Society of Nephrology</a>

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Researchers studied the feasibility of implementing a smartphone support tool for patients with both CKD and hypertension. 

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