Background: The incidence of end-stage renal disease continues to rise annually, with dialysis currently serving as the primary replacement therapy. The effectiveness of dialysis treatment and patients' quality of life are highly dependent on their self-management. Mobile health (mHealth), which provides real-time medical support through portable devices, has become an essential tool for assisting patients undergoing dialysis in optimizing their self-management.
Objective: This study aimed to systematically explore the core elements of self-management in patients undergoing dialysis and clarify the primary applications of mHealth, including types of mHealth, relevant theories and models, mHealth-based interventions, and evaluation indicators.
Methods: This study was guided by Arksey and O'Malley's methodology, PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), and PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Literature Search Extension). Databases, such as PubMed, Embase, CINAHL, PsycINFO, and Web of Science, were systematically searched from January 2010 until October 2025. The participants included in this study were patients undergoing dialysis, and the study design must incorporate quantitative research. Published protocols, reviews, editorials, conference papers, books, and non-English studies were excluded. The Mixed Methods Appraisal Tool was used to evaluate the quality of the included studies. Quantitative studies were extracted, mapped, and summarized. The results were collated and synthesized using a structured spreadsheet.
Results: Out of 1483 relevant studies, this scoping review ultimately selected 34 studies involving 2068 patients undergoing dialysis. Self-management among patients undergoing dialysis in this study included 6 major areas, including self-monitoring, diet and fluid management, medication management, disease-related knowledge, exercise management, and psychological management. Most studies used a single app (n=22) for management of patients undergoing dialysis, followed by 2 or more online interventions (n=6) and a remote patient monitoring system (n=3). The mHealth-based interventions in this study focused on self-monitoring, dietary and fluid management, and medication management. The transtheoretical model and stages of change (n=5), self-efficacy theory (n=4), and social cognitive theory (n=4) were the most commonly used theories. Among the evaluation indicators, interdialytic weight gain (n=12), serum potassium (n=14), serum phosphorus (n=20), and serum albumin (n=14) were the most commonly used objective indicators. Subjective indicators were assessed using scales, primarily covering adherence (n=17), self-efficacy (n=14), quality of life (n=12), knowledge (n=9), and diet and nutrition (n=9).
Conclusions: Although mHealth holds promise for improving self-management and outcomes among patients undergoing dialysis, there remains significant room for advancement. Future research in this field should focus on enhancing adaptive software development, deeply integrating artificial intelligence technologies, addressing the needs of special populations, and establishing a standardized self-management evaluation system. Our findings not only provide a theoretical framework for optimizing clinical management strategies for patients undergoing dialysis but also offer targeted guidance and practical insights for the subsequent development of apps.
Keywords: hemodialysis; kidney; mHealth; mobile health; peritoneal dialysis; self-management.
© Qin Xu, Yulin Xu, Xiaoqin Liu, Xiaolin Ma. Originally published in the Journal of Medical Internet Research (https://www.jmir.org).