47 research outputs found
Sleep‐Disordered Breathing and 24‐Hour Ambulatory Blood Pressure Monitoring in Renal Transplant Patients: Longitudinal Study
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Monitoring Risk Factors and Improving Adherence to Therapy in Patients With Chronic Kidney Disease (Smit-CKD Project): Pilot Observational Study
Background: Chronic kidney disease is a major public health issue, with about 13% of the general adult population and 30%
of the elderly affected. Patients in the last stage of this disease have an almost uniquely high risk of death and cardiovascular
events, with reduced adherence to therapy representing an additional risk factor for cardiovascular morbidity and mortality.
Considering the increased penetration of mobile phones, a mobile app could educate patients to autonomously monitor cardiorenal
risk factors.
Objective: With this background in mind, we developed an integrated system of a server and app with the aim of improving
self-monitoring of cardiovascular and renal risk factors and adherence to therapy.
Methods: The software infrastructure for both the Smit-CKD server and Smit-CKD app was developed using standard
web-oriented development methodologies preferring open source tools when available. To make the Smit-CKD app suitable for
Android and iOS, platforms that allow the development of a multiplatform app starting from a single source code were used. The
integrated system was field tested with the help of 22 participants. User satisfaction and adherence to therapy were measured by
questionnaires specifically designed for this study; regular use of the app was measured using the daily reports available on the
platform.
Results: The Smit-CKD app allows the monitoring of cardiorenal risk factors, such as blood pressure, weight, and blood glucose.
Collected data are transmitted in real time to the referring general practitioner. In addition, special reminders improve adherence
to the medication regimen. Via the Smit-CKD server, general practitioners can monitor the clinical status of their patients and
their adherence to therapy. During the test phase, 73% (16/22) of subjects entered all the required data regularly and sent feedback
on drug intake. After 6 months of use, the percentage of regular intake of medications rose from 64% (14/22) to 82% (18/22).
Analysis of the evaluation questionnaires showed that both the app and server components were well accepted by the users.
Conclusions: Our study demonstrated that a simple mobile app, created to self-monitor modifiable cardiorenal risk factors and
adherence to therapy, is well tolerated by patients affected by chronic kidney disease. Further studies are required to clarify if
the use of this integrated system will have long-term effects on therapy adherence and if self-monitoring of risk factors will
improve clinical outcomes in this population