Abstract: FR-PO1069

An Integrated Smartphone Application Improves Patient Safety and Intervention Adherence: A Randomized Controlled Trial (RCT) with an Active Control Group

Session Information

Category: Patient Safety

  • 1501 Patient Safety

Authors

  • Jassal, Sarbjit Vanita, University Health Network, Toronto, Ontario, Canada
  • Ong, Stephanie W., University Health Network, Toronto, Ontario, Canada
  • Min, Kelly, University Health Network, Toronto, Ontario, Canada
  • Uddin, Akib, University Health Network, Toronto, Ontario, Canada
  • Porter, Eveline C, University Health Network, Toronto, Ontario, Canada
  • Cafazzo, Joseph A., University Health Network, Toronto, Ontario, Canada
  • Seto, Emily, University of Toronto, Toronto, Ontario, Canada
  • Tomlinson, George, University Health Network, Toronto, Ontario, Canada
  • Logan, Alexander G., Mount Sinai Hospital, Toronto, Ontario, Canada
Background

There are a large number of applications (apps) available for chronic kidney disease (CKD) management, but few have been rigorously evaluated in a RCT. We previously published the efficacy of the eKidneyCare App when used to monitor blood pressure (BP), medications, labs and symptoms (CJASN 2016). To establish the clinical effectiveness of using an integrated app system and including customizable algorithms to send real-time feedback we completed a 1-year prospective RCT comparing eKidneyCare (Active) to MyMedRec (Active Control), a widely-recommended, commercially available app that records similar medical information without providing feedback.

Methods

We randomly assigned patients with CKD 3b-5 or 5D, attending an outpatient renal clinic at UHN, to a mobile-health monitoring kit consisting of a Bluetooth-enabled home blood pressure(BP) monitor, and a smartphone preloaded with either the eKidneyCare or MyMedRec app. The primary outcome was the number of medication discrepancies at 1 year. Secondary outcomes included adherence to monitoring regime, use of the app over time, BP at study exit and feedback from patient-questionnaires.

Results

Between May and Sept 2016, a total of 182 adults (mean age, 57 years; 65% (n=118) men; 31% (n=57) diabetics) underwent randomization (93 MyMedRec; 89 eKidneyCare). Median follow up was 11.4 months (84% completed, 10% medical exit, 6% patient withdrawal). Medication discrepancies were more common in the MyMedRec group (mean 7.3, 5.1 in MyMedRec and eKidneyCare respectively; difference -2.2, 95% CI, -3.8 to -1.1). The number of BP readings taken per month was sustained longer and at significantly higher rates in the eKidneyCare group (median readings per month 16.8 vs 8.6, p<0.0001).

Conclusion

In this study, patients allocated to the eKidneyCare app participated more in self-monitoring behaviours and had fewer medication discrepancies than those using the commercially available app. Our results suggest that integration and real-time feedback features in the app are critical components for success.

Funding

  • Private Foundation Support