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Abstract: SA-OR19

Hemodialysis Patient App Promotes Patient Engagement and May Improve Patient Outcomes Such as Hospitalisation and Phosphate Control

Session Information

Category: Augmented Intelligence, Digital Health, and Data Science

  • 300 Augmented Intelligence, Digital Health, and Data Science

Authors

  • Nikam, Milind, Fresenius Medical Care Asia Pacific Ltd, Singapore, Singapore
  • Chan, Cindy, Fresenius Medical Care Asia Pacific Ltd, Singapore, Singapore
  • Cheung, Yan Yi, Fresenius Medical Care Asia Pacific Ltd, Singapore, Singapore
  • Mooppil, Nandakumar, Fresenius Medical Care Singapore Pte Ltd, Singapore, Singapore
  • Li, Margaret, Fresenius Medical Care Asia Pacific Ltd, Singapore, Singapore
  • Hymes, Jeffrey L., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
Background

Mobile applications (apps) have been shown to improve engagement in patients with chronic diseases. The aim of this study was to investigate patient engagement with our patient app (MyCompanion) and assess the impact of app usage on the outcomes of our hemodialysis (HD) patients.

Methods

We conducted a retrospective review of 2,970 chronic HD patients from 33 dialysis clinics in Singapore over a 2-year period (July 2020 - June 2022). An online survey was disseminated to gather user feedback. We compared the demographics, clinical, laboratory and outcome variables between app users and non-users using linear regression, and changes to the variables before and after app usage (1-year period) using paired t-test.

Results

As of June 2022, 13.5% (194 out of 1594 total active in-centre HD patients) of the patients logged in to the app at least once monthly. From the online survey with 64 respondents, a vast majority (87.5%) reported that the app empowered them for self-care. Out of the 5 core features within the app, patients ranked treatment data (39.1%) followed by laboratory results (32.8%) as the most favoured.

For the analysis of outcome variables, 822 app users and 2,148 non-users were identified. App users were statistically significantly younger (60.1 vs 66.0 years), had longer dialysis vintage (3.9 vs 2.0 years), higher dry body weight (70.7 kg vs 65.6 kg in males and 59.3 kg vs 56.7 kg in females) and lower adjusted Charlson Comorbidity Index (5.0 vs 5.5) (p<0.001).

The percentage of patients achieving the phosphate target (≥2.5 and <5.5 mg/dL) was higher in app users (68.9%) compared to non-users (66.4%) (p<0.001). Phosphate control improved after 1 year of app usage from 62.2% to 69.4% (p=0.001).

Hospitalisation rate (events per patient year) was 1.55 for app users and 1.97 for non-users (p<0.001). The number of hospitalization days per patient year for users and non-users were 10.2 and 10.9 days, respectively (p<0.001). The impact of app usage on patients’ interdialytic weight gain was not statistically significant.

Conclusion

HD patient app promotes patient empowerment and self-care. Additionally, app usage may improve medical outcomes such as phosphate and hospitalisation.

Funding

  • Commercial Support – Fresenius Medical Care