JMIR Publications

ABSTRACT

Background:

Chronic kidney disease (CKD) is a global health burden. Self-management plays a key role in improving modifiable risk factors.

Objective:

This study aimed to evaluate the effectiveness of wearable devices, a health management platform, and social media for improving self-management of CKD, with the goal of establishing a new self-management intervention model.

Methods:

In a 90-day prospective experimental study, 60 people with CKD stage 1-4 were enrolled in an intervention group (n=30) and control group (n= 30). All participants were provided with wearable devices that collected exercise-related data. All participants recorded dietary diaries using a smartphone application. All dietary and exercise information was uploaded to a health management platform. Suggestions about diet and exercise were provided to the intervention group only, and a social media group was created to inspire participants in the intervention group. Participants’ self-efficacy and self-management questionnaire scores, Kidney Disease Quality of Life scores, body composition, and laboratory examinations before and after the intervention were compared between intervention and control groups.

Results:

A total of 49 participants completed the study (25 in the intervention group, 24 in the control group); 73.5% were male, and the study group’s mean age was 51.22 years. The measured baseline characteristics of both groups were the same except for educational background. After the intervention, the intervention group had significantly higher scores for self-efficacy (171.28±22.92 vs. 142.21±26.36, P<.001) and self-management (54.16±6.71 vs. 47.58±6.42, P=.001). Kidney Disease Quality of Life scores were also higher in the intervention group (293.16±34.21 vs. 276.37±32.21, P=.021). Number of steps per day increased in the intervention group (9,768.56 in week 1, then 11,389.12 in week 12). The estimated glomerular filtration rate (eGFR) of the intervention group was higher than that of the control group (72.47±24.28 vs. 59.69±22.25 mL/min/1.73m2, P=.025), and the decline in eGFR was significantly slower in the intervention group (–0.56 vs. –4.58 mL/min/1.73m2). There were no differences in body composition between groups post intervention.

Conclusions:

The application of wearable devices, a health management platform, and social media support not only strengthened self-efficacy and self-management but improved quality of life and slowed eGFR decline in people with CKD stage 1-4. These results outline a new self-management model to promote healthy lifestyle behaviors in CKD patients.