JMIR Publications

ABSTRACT

Background:

Mobile technology has an impact on the healthcare sector, also within dietetics. Mobile health applications may be used for dietary assessment and self-monitoring, allowing for real-time reporting of food intakes. Changing eating behaviors is quite challenging, and hemodialysis patients, particularly, struggle to meet the target intakes set by dietary guidelines. Usage of mobile apps that are developed in a person-centered approach and that are in line with recommendations may support both patients and healthcare practitioners

Objective:

This study is a pilot that aims at estimating the potential efficacy of a dietary intervention using a theory-based, person-centered smartphone app. Results will be used to improve both the application and a planned large-scale trial intended to assess app efficacy thoroughly.

Methods:

A prospective pilot study was performed at the hemodialysis unit of Al Qassimi Hospital (Emirate of Sharjah). All patients that fulfilled the study inclusion criteria were considered eligible to be enrolled in the pilot study. Upon successful installation of the app, users met with a dietitian once a week. Outcomes were measured at baseline (T0) and two weeks post app usage (T1). This pilot is reported as per guidelines for non-randomized pilot and feasibility studies and in line with the CONSORT 2010 checklist for reporting pilot or feasibility trials

Results:

Twenty-three subjects completed the pilot intervention. Mean energy intakes increased from 24.4 Kcal/kg/d (8.0) to 29.1 Kcal/kg/d (7.8) with a medium effect size (d= 0.6; 95%CI 0.0-1.2). Mean protein intakes increased from 0.9g/kg/d (0.3) to 1.3 g/kg/d (0.5) with a large effect size (d= 1.0; 95%CI 0.4-1.6); intake of high biological value proteins (%HBV) also increased from 58.6% (10.1) to 70.1% (10.7) with a large effect size (d=1.1; 95%CI 0.5-1.7). Dietary intakes of minerals did not change, apart from sodium which decreased from an intake of 2218.8mg/d (631.6) to 1895.3mg/d (581.0) with a medium effect size (d=0.5; 95%CI 0.1-1.1). Serum phosphorus, potassium and albumin did not change relevantly. Serum iron increased from 7.9mg/dl (2.8) to 11.5mg/dl (7.9) post-intervention with a medium effect size (d= 0.6; 95%CI 0.0-1.2).

Conclusions:

This pilot study showed that KELA.AE app has the potential to improve dietary intakes. Processes related to procedure, resources, tools and app improvement for a future trial were assessed. A more extended intervention using a randomized controlled trial is required to estimate parameters concerning app efficacy accurately.