JMIR Publications

ABSTRACT

Background:

The integration of mobile health (mHealth) applications into chronic kidney disease (CKD) care holds transformative potential to enhance patient self management and slow disease progression. Patients with CKD, who are often older and have multiple comorbidities, play a central role in the success of mHealth assisted self management; their acceptance and sustained use of these tools critically determine implementation outcomes. Despite the growing proliferation of mHealth applications, there remains a limited understanding of the factors that facilitate or hinder their use among CKD patients. A clear comprehension of these influencing factors is essential to foster the effective, equitable, and sustainable integration of mHealth into routine CKD self management support.

Objective:

To analyze facilitators and barriers to the use of mHealth applications for self-management in patients with CKD, and to provide evidence to guide the development of intervention strategies.

Methods:

A systematic search was performed across CNKI, WanFang Data, VIP Database, Chinese Medical Journals Database, PubMed, CINAHL, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science Core Collection to identify relevant literatures on mHealth-facilitated self-management in patients with CKD. The search period ranged from database inception to May 2026. Two researchers independently assessed the quality of the included studies and applied the updated Consolidated Framework for Implementation Research 2.0 (CFIR 2.0) to categorize the facilitators and barriers.

Results:

A total of 13 studies involving 2,881 CKD patients were included. A total of 21 barriers and 22 facilitators were identified and grouped into five domains based on the updated CFIR 2.0: innovation, outer setting, inner setting, individual characteristics, and implementation process. The most common facilitators were a simple and easy to use interface, convenient, anytime, and rapid access to health information and care and support from family members and peers. The most prominent barriers were low health literacy, advanced age, lack of access to devices (no smartphone/internet), and poor economic status of patients.

Conclusions:

The use of mHealth applications for self-management in CKD patients is influenced by multi-level factors. Identifying key facilitators and barriers and developing targeted strategies are essential to enhance implementation effectiveness. Clinical Trial: PROSPERO CRD420261394369; Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420261394369.