Abstract: TH-PO208
Patient Engagement with a Digital Health Intervention (patientMpower) to Optimise Interdialytic Fluid Management in Ambulatory Hemodialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hudson, Amy, Beaumont Hospital, Dublin, Ireland
- Vasu, Binu, Beaumont Hospital, Dublin, Ireland
- Edwards, Colin, patientMpower, Dublin, Ireland
- Holmes, Martin, patientMpower, Dublin, Ireland
- Doyle, Kevin, patientMpower, Dublin, Ireland
- Sexton, Donal J., Trinity Health Kidney Center, Trinity College Dublin, Dublin, Ireland
- O'Seaghdha, Conall M., Beaumont Hospital, Dublin, Ireland
Background
Many aspects of a chronic illness rely heavily on patient self-care and engagement. While promising, studies on the use of digital medicine platforms to empower patients to self-manage have suffered from low patient engagement.
This pilot-scale study (NCT03403491) evaluated a mobile digital health intervention+weighing scales+blood pressure (BP) meter [patientMpower intervention (pMp)] in ambulatory hemodialysis patients treated in a clinical setting. Patient-reported weight and BP were captured by wireless connection to pMp (cellular or Bluetooth).
Methods
43 patients (28M/15F; age 51±14y) entered an open-label, randomised, random-order, 2 x 28-day crossover comparison of pMp vs. a sham intervention. Patients were asked to record weight, BP, symptoms, fluid intake & medicines adherence every day during the pMp period. pMp calculated and displayed weight gain relative to individualised target (dry) weight to each patient. An algorithm within pMp delivered tailored feedback messages (dependent on actual weight gain) to optimise fluid intake between dialysis sessions. Primary endpoint was patient engagement with pMp.
Results
Engagement was high. 35 patients (81%) recorded weight on ≥21 days of the pMp period. Engagement metrics in the 28-day pMp period are shown below.
However, only 2 patients recorded medicines adherence on pMp. Patients were asked to complete an online survey to feed back opinion of pMp. 23 gave feedback. 19(83%) reported pMp gave them a greater sense of control & had positive impact on their well-being, 18(78%) wished to continue using pMp after study, 21(91%) rated pMp as easy to use and 15(65%) liked using pMp (score ≥8/10 on rating scale).
Conclusion
This study demonstrated that ambulatory hemodialysis patients are willing and engaged in using a mobile digital health intervention with connected devices to regularly monitor body weight and BP to help them optimise fluid intake. The high engagement by these patients suggests that this methodological approach could be useful in future studies of optimisation of dry weight estimation and/or fluid intake.
Funding
- Commercial Support –