Monitoring risk factors and improving adherence to therapy in CKD patients. The SMIT-CKD project. (Preprint)

Abstract

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 wide spreading of mobile phones, a mobile app could educate patients in self-monitoring cardio-renal risk factors. OBJECTIVE To develop an integrated system to educate patients in self-monitoring cardio-renal risk factors. METHODS We developed an integrated system made by a server and an app, with the aim of improving self-monitoring of cardiovascular and renal risk factors and of improving adherence to therapy. RESULTS The SMIT-CKD APP allows the monitoring of cardio-renal risk factors and their transmission to the referring GP. Special reminders help drug administration. Via the SMIT-CKD Server, GPs can monitor the clinical status of their patients and adherence to therapy. During the test, 73% of subjects entered all the required data regularly and sent feedbacks of drug intake. Looking at the evaluation questionnaires, both the app and the server counterpart were well accepted by the users. CONCLUSIONS Our study demonstrated that a simple Mobile APP, created to self-monitor modifiable cardio-renal risk factor 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. CLINICALTRIAL NA