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Abstract: TH-PO049

Empowering Dialysis Patients to Self-Manage Hyperphosphatemia with Mobile Health Technology: Insights from the FOSFO-OK Study

Session Information

Category: Bioengineering

  • 400 Bioengineering

Authors

  • Hueso, Miguel, Hospital Universitari de Bellvitge Servei de Nefrologia, L'Hospitalet de Llobregat, Catalunya, Spain
  • Rodriguez Urquia, Ronny I., Hospital Universitari de Bellvitge Servei de Nefrologia, L'Hospitalet de Llobregat, Catalunya, Spain
  • Alvarez Esteban, Rafael, Hospital Universitari de Bellvitge Servei de Nefrologia, L'Hospitalet de Llobregat, Catalunya, Spain
  • Quero, Maria, Hospital Universitari de Bellvitge Servei de Nefrologia, L'Hospitalet de Llobregat, Catalunya, Spain
  • Villalobos, Gustavo E., Diaverum Espana, Coslada, Madrid, Spain
  • Galofre, Claudia, Institut d'Investigacio Biomedica de Bellvitge, Barcelona, Catalunya, Spain
  • Peiró-Jordán, Roser, CSL-VIFOR, Barcelona, Spain
  • Martínez, David Marí, Technology Centre of Catalonia Eurecat, Barcelona, Spain
  • Vellido, Alfredo, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain

Group or Team Name

  • FOSFO-OK.
Background

mHealth apps are cost-effective technologies that can assist dialysis patients in achieving their therapeutic goals. Since many patients fail to control their phosphate levels, the main objective of this project is to develop a mHealth environment that empowers CKD patients to self-management their hyperphosphatemia under medical supervision. Such an environment will allow nephrologists to provide patients with information beyond their traditional point of care and enable patients to receive timely feedback on their condition.

Methods

We developed a web-based management system that delivers patient’s phosphate levels results and medical recommendations through a cloud-based IT environment. Patients with phosphate levels > 6 mg/dL and PTH <88 pmoL/L were included in the study. Patients were randomly assigned to receive the app or continue with the usual educational program. Changes in phosphate binders or vitamin D were allowed and analytical results were collected monthly. The degree of satisfaction of patients and nephrologists was evaluated.

Results

The study included 42 patients (21 in each group). The baseline phosphate levels were 6.94±1.43 mg/dL in the group that received the app vs 6.61±0.99 in the control group (p=ns). At the 3-month follow-up, the group that use the app had a phosphate of 5.64±1.73 mg/dL (81% of the patients reduced phosphate levels), while only 57% of the patients in the control group managed to reduce their phosphate level, with mean levels of 6.06±1.44 mg/dL (p=0.018). These results were maintained at 6 months, and 82% of the patients with the app had improved their phosphate levels, compared to only 56% of the patients who did not use the app. Patients who used the app found it to be useful, and nephrologists were also satisfied with the app.

Conclusion

Patient benefits from a virtual assistant via their smartphone, through an integrated system of participatory, personalized, predictive, and preventive medicine. This study demonstrates that virtual tools through a participatory and personalized medicine system help CKD patients to control hyperphosphatemia.

Funding

  • Commercial Support – CSL Vifor