Testing the Feasibility and Usability of a Novel Smartphone-Based Self-Management Support System for Dialysis Patients: A Pilot Study

Aki Hayashi; Satoko Yamaguchi; Kayo Waki; Katsuhito Fujiu; Norio Hanafusa; Takahiro Nishi; Hyoe Tomita; Haruka Kobayashi; Hideo Fujita; Takashi Kadowaki; Masaomi Nangaku; Kazuhiko Ohe

doi:10.2196/resprot.7105

Testing the Feasibility and Usability of a Novel Smartphone-Based Self-Management Support System for Dialysis Patients: A Pilot Study

JMIR Res Protoc. 2017 Apr 20;6(4):e63. doi: 10.2196/resprot.7105.

Authors

Aki Hayashi¹, Satoko Yamaguchi¹, Kayo Waki^{1

2}, Katsuhito Fujiu^{1

3}, Norio Hanafusa^{4

5}, Takahiro Nishi⁶, Hyoe Tomita⁷, Haruka Kobayashi⁸, Hideo Fujita¹, Takashi Kadowaki², Masaomi Nangaku⁹, Kazuhiko Ohe¹⁰

Affiliations

¹ Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
² Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴ Division of Total Renal Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.
⁵ Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
⁶ Nishi Clinic, Tokyo, Japan.
⁷ Yuujin Clinic, Tokyo, Japan.
⁸ Business Development of Healthcare Business Smart-Life Solutions Department, NTT DOCOMO, Inc, Tokyo, Japan.
⁹ Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁰ Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Abstract

Background: Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management.

Objective: Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients.

Methods: We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations. Data is displayed graphically, with all data evaluated automatically to determine whether they achieve the values suggested by the Japanese Society for Dialysis Therapy guidelines. In a pilot study, 9 dialysis patients used SMART-D system for 2 weeks. A total of 7 of them completed questionnaires rating their assessment of SMART-D's usability and their satisfaction with the system. In addition, the Kidney Disease Quality of Life scale was compared before and after the study period.

Results: All 9 participants were able to use SMART-D with no major problems. Completion rates for body weight, pre- and postdialysis weight, and serum potassium and phosphorus concentrations were, respectively, 89% (SD 23), 95% (SD 7), and 78% (SD 44). Of the 7 participants who completed the usability survey, all were motivated by the sense of security derived from using the system, and 6 of the 7 (86%) reported that using SMART-D helped improve their lifestyle and self-management.

Conclusions: Using SMART-D was feasible, and the system was well regarded by patients. Further study with larger scale cohorts and longer study and follow-up periods is needed to evaluate the effects of SMART-D on clinical outcomes and quality of life.

Keywords: hemodialysis; mobile phone app; self-management; telemedicine.

©Aki Hayashi, Satoko Yamaguchi, Kayo Waki, Katsuhito Fujiu, Norio Hanafusa, Takahiro Nishi, Hyoe Tomita, Haruka Kobayashi, Hideo Fujita, Takashi Kadowaki, Masaomi Nangaku, Kazuhiko Ohe. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.04.2017.