JMIR Publications

ABSTRACT

Background:

Chronic kidney disease (CKD) requires sustained self-management involving complex medication regimens, dietary restrictions, and symptom monitoring. These demands pose substantial challenges to medication adherence and daily disease management. Digital therapeutics (DTx) have the potential to support CKD self-management; however, CKD-specific design requirements informed by both patient and clinician perspectives remain insufficiently explored.

Objective:

This study aimed to identify key design requirements for CKD-specific digital therapeutics by integrating patient-reported self-management challenges with nephrologist perspectives on clinical needs and implementation considerations.

Methods:

A convergent mixed-methods study was conducted at a tertiary academic hospital. Quantitative data were collected through a structured survey of 60 adults with non–dialysis-dependent CKD to assess medication adherence challenges, digital health needs, and age-related differences. Qualitative data were obtained through focus group interviews with 19 nephrologists and analyzed using thematic analysis. Quantitative and qualitative findings were integrated to identify convergent priorities and design implications for CKD-specific DTx.

Results:

None of the patients reported prior experience with CKD-specific digital health applications, although 70% perceived a need for such tools. Younger patients (<60 years) expressed significantly greater interest in digital therapeutics than older patients (83.9% vs 55.2%, P=.015). Common patient-reported challenges included managing multiple medications (36.7%), irregular medication schedules (30.0%), and difficulty understanding medication timing relative to meals (28.3%). Nephrologists emphasized the importance of personalized medication reminders, comprehensive medication information (including adverse effects and nephrotoxic risks), symptom-monitoring systems, and features supporting dietary and lifestyle management. Integration findings highlighted the need for user-friendly, age-sensitive interfaces, data security, and clinically actionable feedback mechanisms.

Conclusions:

By integrating patient and nephrologist perspectives, this mixed-methods study identifies key design considerations for CKD-specific digital therapeutics. These findings provide formative, design-informed evidence to guide the early development of patient-centered and clinically relevant digital therapeutics for CKD.