The effects of a digital health intervention on patient activation in chronic kidney disease

IF 12.4 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

NPJ Digital Medicine Pub Date : 2024-11-12 DOI:10.1038/s41746-024-01296-1

Courtney J. Lightfoot, Thomas J. Wilkinson, Gurneet K. Sohansoha, Clare L. Gillies, Noemi Vadaszy, Ella C. Ford, Melanie J. Davies, Thomas Yates, Alice C. Smith, Matthew P. M. Graham-Brown, On behalf of SMILE-K collaborators

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Abstract

My Kidneys & Me (MK&M), a digital health intervention delivering specialist health and lifestyle education for people with CKD, was developed and its effects tested (SMILE-K trial, ISRCTN18314195, 18/12/2020). 420 adult patients with CKD stages 3–4 were recruited and randomised 2:1 to intervention (MK&M) (n = 280) or control (n = 140) groups. Outcomes, including Patient Activation Measure (PAM-13), were collected at baseline and 20 weeks. Complete case (CC) and per-protocol (PP) analyses were conducted. 210 (75%) participants used MK&M more than once. PAM-13 increased at 20 weeks compared to control (CC: +3.1 (95%CI: −0.2 to 6.4), P = 0.065; PP: +3.6 (95%CI: 0.2 to 7.0), P = 0.041). In those with low activation at baseline, significant between-group differences were observed (CC: +6.6 (95%CI: 1.3 to 11.9), P = 0.016; PP: +9.2 (95%CI: 4.0 to 14.6), P < 0.001) favouring MK&M group. MK&M improved patient activation in those who used the resource compared to standard care, although the overall effect was non-significant. The greatest benefits were seen in those with low activation.

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数字健康干预对慢性肾病患者积极性的影响

我的肾&我（MK&M）是一种为慢性肾功能衰竭患者提供专业健康和生活方式教育的数字健康干预措施，该干预措施已开发完成并进行了效果测试（SMILE-K 试验，ISRCTN18314195，18/12/2020）。该试验招募了 420 名慢性肾功能衰竭 3-4 期的成年患者，并按 2:1 随机分配到干预组（MK&M）（n = 280）或对照组（n = 140）。在基线和 20 周时收集结果，包括患者激活测量（PAM-13）。进行了完整病例 (CC) 和每方案 (PP) 分析。210名参与者（75%）使用过一次以上 MK&M。与对照组相比，PAM-13 在 20 周时有所增加（CC：+3.1（95%CI：-0.2 至 6.4），P = 0.065；PP：+3.6（95%CI：0.2 至 7.0），P = 0.041）。在基线激活度较低的人群中，观察到了显著的组间差异（CC：+6.6（95%CI：1.3 至 11.9），P = 0.016；PP：+9.2（95%CI：4.0 至 14.6），P <0.001），MK&M 组更胜一筹。与标准护理相比，MK&M提高了使用该资源的患者的积极性，但总体效果并不显著。激活度较低的患者获益最大。

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来源期刊

NPJ Digital Medicine Multiple-

CiteScore

25.10

自引率

3.30%

发文量

170

审稿时长

15 weeks

期刊介绍： npj Digital Medicine is an online open-access journal that focuses on publishing peer-reviewed research in the field of digital medicine. The journal covers various aspects of digital medicine, including the application and implementation of digital and mobile technologies in clinical settings, virtual healthcare, and the use of artificial intelligence and informatics. The primary goal of the journal is to support innovation and the advancement of healthcare through the integration of new digital and mobile technologies. When determining if a manuscript is suitable for publication, the journal considers four important criteria: novelty, clinical relevance, scientific rigor, and digital innovation.