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一款移动健康应用程序对日本慢性肾脏病患者自我管理的疗效

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

作者信息

Suetsugu-Ishizawa Reina, Sakuma Hirofumi, Matsuki Motoki, Itano Seiji, Nagasu Hajime, Morinaga Hiroshi, Uchida Haruhito A, Kuwabara Takashige, Imasawa Toshiyuki, Yamada Kazuki, Nakagawa Naoki

机构信息

Division of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Japan.

Department of Nephrology and Hypertension, Kawasaki Medical School, Okayama, Japan.

出版信息

Clin Exp Nephrol. 2025 Jun 2. doi: 10.1007/s10157-025-02713-9.

Abstract

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.

摘要

目的

药物依从性差会削弱慢性肾脏病(CKD)循证治疗的疗效。本研究评估移动健康(mHealth)应用程序KaKalink是否通过提供健康相关信息来改善患者的自我管理。

方法

在这项为期32周的开放标签、干预前后试验中,从肾脏病门诊医院招募了119例CKD患者(74例男性,占62%)。先有一个8周的非干预期(A期),随后是一个24周的干预期(B期)。在干预期,参与者每两周通过KaKalink接收一次健康相关信息。评估药物依从性输入率以及血压(BP)和体重(BW)测量输入率的变化。使用KaKalink进行了满意度调查。

结果

患者的平均(标准差)年龄为53.3(11.9)岁。A期前的平均晨起和夜间血压分别为121.0(9.5)/76.0(7.8)mmHg和117.7(11.0)/72.5(9.2)mmHg。药物依从性输入率的均值从A期的68.0%(95%置信区间[CI]60.1 - 75.8%)降至B期的60.2%(95%CI 52.1 - 68.4%)(p < 0.0001),女性的依从性高于男性。BP和BW测量输入率也观察到类似的下降趋势。通过问卷调查,大多数参与者对mHealth应用程序的使用表示高度满意。

结论

通过KaKalink提供的信息并未显著改善依从性或BP及BW的变化;然而,大多数参与者认为该应用程序是增强自我管理的有用且非常令人满意的工具。

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