Functionality and sustainability of telemedicine for home-based management of patients with chronic kidney disease: the telemechron study.

Abstract

Background: Chronic kidney disease (CKD) is a global health concern, contributing to high morbidity, mortality, and cardiovascular risk. Intensive monitoring of clinical parameters and timely therapeutic interventions can improve disease management.

Methods: This study developed and tested a telemonitoring system using wearable sensors and a smartphone app to support chronic kidney disease patients on dialysis or during pre-dialysis care. The system was evaluated for its feasibility and sustainability, analyzing the usability, patient adherence, and potential impact on healthcare outcomes. Eight patients tested the prototype.

Results: Results showed that the overall protocol adherence rate was 8.8%, much lower than expected. Patients enrolled in pre-dialysis care demonstrated higher adherence compared to patients living with hemodialysis or peritoneal dialysis. While most users found the system intuitive, some reported that the time requested for measurements was excessive. Recommendations for further development include improving reminder notifications and using multi-parametric devices to streamline data collection.

Conclusions: In patients with CKD, intensive remote monitoring could allow the acquisition of clinical data to facilitate achievement of clinical targets by timely therapeutic adjustments. However, long-term monitoring was not widely accepted. Further testing with larger samples and future refinements, integrating miniaturized wearable devices and AI-driven analytics, could enhance adherence and personalized care.