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. 2024 Nov 12;7(1):318.
doi: 10.1038/s41746-024-01296-1.

The effects of a digital health intervention on patient activation in chronic kidney disease

Courtney J Lightfoot  1   2 , Thomas J Wilkinson  3   4   5 , Gurneet K Sohansoha  3 , Clare L Gillies  6 , Noemi Vadaszy  3   4 , Ella C Ford  3   4 , Melanie J Davies  4   5 , Thomas Yates  4   5 , Alice C Smith  3   4 , Matthew P M Graham-Brown  7   8 ; SMILE-K collaborators
Collaborators, Affiliations

The effects of a digital health intervention on patient activation in chronic kidney disease

Courtney J Lightfoot et al. NPJ Digit Med. .

Abstract

My Kidneys & Me (MK&M), a digital health intervention delivering specialist health and lifestyle education for people with CKD, was developed and its effects tested (SMILE-K trial, ISRCTN18314195, 18/12/2020). 420 adult patients with CKD stages 3-4 were recruited and randomised 2:1 to intervention (MK&M) (n = 280) or control (n = 140) groups. Outcomes, including Patient Activation Measure (PAM-13), were collected at baseline and 20 weeks. Complete case (CC) and per-protocol (PP) analyses were conducted. 210 (75%) participants used MK&M more than once. PAM-13 increased at 20 weeks compared to control (CC: +3.1 (95%CI: -0.2 to 6.4), P = 0.065; PP: +3.6 (95%CI: 0.2 to 7.0), P = 0.041). In those with low activation at baseline, significant between-group differences were observed (CC: +6.6 (95%CI: 1.3 to 11.9), P = 0.016; PP: +9.2 (95%CI: 4.0 to 14.6), P < 0.001) favouring MK&M group. MK&M improved patient activation in those who used the resource compared to standard care, although the overall effect was non-significant. The greatest benefits were seen in those with low activation.

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Conflict of interest statement

Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. My Kidneys & Me dashboard and features.
Illustration of the My Kidneys & Me dashboard and key features.
Fig. 2
Fig. 2. CONSORT diagram.
Flowchart depicting progress through the trial phases.
Fig. 3
Fig. 3. Changes in PAM-13 score from baseline to week 20.
a CC analysis - includes all participants who completed PAM-13. b PP analysis - includes those who logged in, created an account and used the programme more than once. Data is shown as mean and standard deviation.
Fig. 4
Fig. 4. Changes in PAM-13 score from baseline to week 20 for participants with low and high baseline patient activation.
a CC analysis - includes all participants who completed PAM-13. b PP analysis - includes those who logged in, created an account and used the programme more than once. Data shown as mean and standard deviation. High baseline group was defined as those with PAM-13 Levels 3 and 4, low baseline group was defined as those with PAM-13 Levels 1 and 2. Horizontal dashed lines indicate the cut-off between low and high activation.
See this image and copyright information in PMC

References

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