JMIR Publications

ABSTRACT

Background:

To improve self-management in people with chronic kidney disease (CKD), we developed My Kidneys & Me (MK&M), a digital health intervention (DHI) that delivers specialist health and lifestyle education.

Objective:

We explored the uptake and usability of MK&M, alongside patient experiences of using the program.

Methods:

Adult patients with CKD stages 3-4 were recruited from 26 hospital kidney services in England. 420 participants were randomised 2:1 to intervention (MK&M) or control (usual care) group. Uptake and usage data were collected from MK&M program, and the perceived usefulness of the MK&M sessions and features were collected via online surveys (scores rated out of 1, where 0 = ‘not useful at all’, and 10 = ‘very useful’). Qualitative (semi-structured and think-aloud) interviews explored participants’ experiences of using and engaging with MK&M. Descriptive and frequency analyses were used to assess usage metrics, and thematic analysis was used to analyse qualitative data.

Results:

280 participants were randomised to receive MK&M (age 60.8±12.8 years, 58% male, eGFR 38.9±18.5 ml/min/1.73m2). 225 (80%) participants activated and used their MK&M account. The median number of logins per person was 10.0 (IQR 4.0-28.0). The median time per login was 12 mins (IQR 7-25). ‘The kidneys’ was the most accessed session (n=152, 68%). The educational sessions were the most valued and engaged content, whilst health and symptom trackers were the least used features. All sessions received scores ≥7 out of 10 for perceived usefulness, with ‘Kidney disease and general health’ considered most useful (8.7/10). Goal setting for health behaviours was considered the most useful tracker (8.5/10) and symptoms the least (6.7/10). A total of 33 participants were interviewed (six think-aloud, 27 semi-structured). Themes relating to usage, usability, and (current and ongoing) engagement with MK&M were identified. MK&M was well-received by participants, with many reporting that the user interface was easy to use, with clear and logical navigation and appropriate presentation of information. Learning sessions were more widely accessed and used than the action (‘How to …’) sessions, with participants highlighting not having enough time to engage with all of the MK&M content in the study period. MK&M users had positive experiences of using the program; however, there was ambivalence regarding content and features, which could be explained by personal preference rather than usability issues. Participants had a desire for continued learning and perceived the relevance of MK&M to be greater with time and disease progression.

Conclusions:

The MK&M DHI was well received and used by participants. Our findings show that a wide range of people with CKD, including older adults, are capable and willing to use DHIs for kidney health. Identification of real-life usage and usability issues will help refine MK&M to improve the content and delivery for clinical implementation. Clinical Trial: ISRCTN18314195