Efficacy of a mobile health application on self-management among Japanese patients with chronic kidney disease

Objective: Poor medication adherence undermines evidence-based treatment efficacy in chronic kidney disease (CKD). This study evaluated whether the mobile health (mHealth) application, KaKalink, improves patient self-management by delivering health-related information. Methods: In this 32-week, open-label, pre- and post-intervention trial, 119 patients (74 men, 62%) with CKD were recruited from nephrology outpatient hospitals. An 8-week non-intervention period (Period A) was followed by a 24-week intervention period (Period B). During the intervention period, the participants received health-related information via KaKalink every two weeks. Changes in the medication adherence input rate and blood pressure (BP) and body weight (BW) measurement input rates were evaluated. A satisfaction survey was conducted using KaKalink. Results: The mean (standard deviation) patient age was 53.3 (11.9) years. The mean morning and evening BP in pre-Period A were 121.0 (9.5)/76.0 (7.8) mmHg and 117.7 (11.0)/72.5 (9.2) mmHg, respectively. The mean medication adherence input rate decreased from 68.0% (95% confidence interval [CI] 60.1–75.8%) in Period A to 60.2% (95% CI 52.1–68.4%) in Period B (p < 0.0001), with women showing higher adherence than men. Similar declining trends were observed for BP and BW measurement input rates. Most participants reported high satisfaction with the mHealth application usage via the questionnaire survey. Conclusions: The information provided via KaKalink did not significantly improve adherence or changes in BP or BW; however, most participants perceived the application to be a useful and highly satisfactory tool for enhancing their self-management.