Kidney Week

Abstract: SA-OR011

Impact on Blood Pressure of Mobile-Based Application (eKidneyCare) in Patients with CKD: A Randomized Controlled Trial

Session Information

• CKD: Health Services, Disparities, Prevention
  November 04, 2017 | Location: Room 282, Morial Convention Center
  Abstract Time: 04:30 PM - 04:42 PM

Category: Chronic Kidney Disease (Non-Dialysis)

• 307 CKD: Health Services, Disparities, Prevention

Authors

• Ong, Stephanie W., University Health Network, Toronto, Ontario, Canada

Stephanie W. Ong, PharmD



Stephanie Ong received her Bachelor of Science in Pharmacy from the University of Toronto in 2001 and further expanded her training by receiving her Masters of Science in Health Informatics in 2010. She is a clinical pharmacist in Nephrology with the University Health Network in Toronto, Canada where she is actively involved in the management of patients with chronic kidney disease. Her main research interests lie with developing and implementing electronic tools to promote self-management strategies in patients with chronic kidney disease and enhance their medication management. Along with her clinical role, Stephanie is presently the clinical project lead with the Division of Nephrology where she leads the development digital tools such as the My KidneyCare kiosk and eKidneyCare mobile app. She has presented the above work extensively in both national and international conferences.

• Jassal, Sarbjit Vanita, University Health Network, Toronto, Ontario, Canada

Sarbjit Vanita Jassal,

• Min, Kelly, University Health Network, Toronto, Ontario, Canada

Kelly Min,

• Uddin, Akib, University Health Network, Toronto, Ontario, Canada

Akib Uddin,

• Porter, Eveline C, University Health Network, Toronto, Ontario, Canada

Eveline C Porter,

• Tomlinson, George, University Health Network, Toronto, Ontario, Canada

George Tomlinson,

• Logan, Alexander G., Mount Sinai Hospital, Toronto, Ontario, Canada

Alexander G. Logan,

Background

We have previously demonstrated feasibility and acceptability of an integrated app (eKidneyCare) used for CKD management (CJASN 2016). It allows patients to monitor blood pressure (BP), manage medication, assess symptoms and track laboratory results. Customizable algorithms provide real-time personalized patient feedback and alerts to providers. Currently we are performing a one-year randomized controlled trial comparing eKidneyCare (intervention) to MyMedRec (control). The latter is a commercially available app that records medical information without providing feedback. Study midpoint results are presented.

Methods

Consenting patients with CKD 3b-5 or 5D were recruited from 6 out-patient renal clinics or dialysis units at University Health Network (UHN) and randomized to eKidneyCare or MyMedRec monitoring. Outcome assessments include BP at 6 and 12 months and medication reconciliation, questionnaires on self-management and, at study end, in-person interviews.

Results

A total of 182 patients were enrolled and randomly allocated to the intervention (n=89) or the control (n=93) group. A total of 157 patients completed the 6 month BP assessment using the automated oscillometric device, BpTRU. Premature withdrawals included 11 transferred or incomplete data, 8 who withdrew consent and 6 withdrawn after medical complications. At 6m, the fall in BP of patients with uncontrolled hypertension at baseline was greater in the active (eKidneyCare) group (median reduction in systolic BP mmHg -18 vs 13 mmHg respectively, p =0.05; diastolic BP 9 vs 5.5 mmHg p=0.03). There was no between group difference in normotensive patients.

Conclusion

Hypertensive patients allocated to the eKidneyCare app had a significantly lower BP than those using the commercially available app. This preliminary analysis suggests that real time patient feedback and integrated mobile apps are critical components for success with mHealth monitoring.

Funding

• Other NIH Support