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Kidney Week

Abstract: SA-OR17

Improving Patient Activation via a Novel Digital Health Intervention: My Kidneys and Me, a Multicenter Randomized Controlled Trial

Session Information

Category: Augmented Intelligence, Digital Health, and Data Science

  • 300 Augmented Intelligence, Digital Health, and Data Science

Authors

  • Lightfoot, Courtney Jane, University of Leicester, Leicester, United Kingdom
  • Wilkinson, Thomas James, University of Leicester, Leicester, United Kingdom
  • Graham-Brown, Matthew, University of Leicester, Leicester, United Kingdom
  • Smith, Alice C., University of Leicester, Leicester, United Kingdom
Background

Self-management is an important component of chronic kidney disease (CKD) healthcare which requires knowledge, skills and confidence (patient activation). Evidence-based and theory-driven resources to support self-management are lacking but digital health interventions (DHIs) may offer cost-effective and equitable education delivery. We co-produced My Kidneys & Me (MK&M), an educational DHI, and tested its effect on patient activation in a multicenter randomized control trial.

Methods

Patients from 26 sites in England were randomized 2:1 to intervention (MK&M) or control groups. MK&M provided theory-based education sessions and trackers for goals, symptoms, physical activity and clinical measures. The Patient Activation Measure (PAM-13) was collected at baseline, 10 and 20 weeks. A 4-point increase in PAM-13 was deemed a meaningful important difference. Intention-to-treat (ITT) and per-protocol (PP) analyses (including patients who used MK&M at least once) were conducted.

Results

421 patients (mean age 59.9±13.4 years, 60% males, eGFR 39.5±24.6 ml/min/1.73m2) were recruited: 281 randomized to receive MK&M, 140 to control. 205 (73%) participants used MK&M at least once. Changes in PAM-13 are shown in Figure 1. Significant between group differences in PAM-13 were observed at 20 weeks in PP analysis. In those with low PAM-13 at baseline, MK&M significantly improved PAM-13 by 9.3-11.4 points. No changes were seen in those with high baseline PAM-13 scores.

Conclusion

Use of the MK&M DHI increased patient activation (measure of self-management). Greater benefit was seen with frequent and sustained usage, and in those with low PAM-13. As higher patient activation is associated with better outcomes, MK&M may improve CKD healthcare management.

Figure 1