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The effects of a digital health intervention on patient activation in chronic kidney disease
npj Digital Medicine ( IF 12.4 ) Pub Date : 2024-11-12 , DOI: 10.1038/s41746-024-01296-1
Courtney J. Lightfoot, Thomas J. Wilkinson, Gurneet K. Sohansoha, Clare L. Gillies, Noemi Vadaszy, Ella C. Ford, Melanie J. Davies, Thomas Yates, Alice C. Smith, Matthew P. M. Graham-Brown

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.



中文翻译:


数字健康干预对慢性肾病患者激活的影响



My Kidneys & Me (MK&M),一种为慢性肾病患者提供专业健康和生活方式教育的数字健康干预已经开发出来并测试了其效果(SMILE-K试验,ISRCTN18314195,2020年12月18日)。招募了 420 名患有 CKD 3-4 期的成年患者,并以 2:1 的比例随机分配到干预组 (MK&M) (n = 280) 或对照组 (n = 140) 组。在基线和 20 周时收集结果,包括患者激活测量 (PAM-13)。进行完整病例 (CC) 和每方案 (PP) 分析。210 名 (75%) 参与者不止一次使用 MK&M。与对照组相比,PAM-13 在 20 周时增加(CC:+3.1(95%CI:-0.2 至 6.4),P = 0.065;PP:+3.6 (95%CI: 0.2 至 7.0),P = 0.041)。在基线时激活度低的患者中,观察到显著的组间差异(CC:+6.6(95%CI:1.3 至 11.9),P = 0.016;PP:+9.2 (95%CI: 4.0 至 14.6),P < 0.001) 有利于 MK&M 组。与标准护理相比,MK&M 改善了使用该资源的患者的激活,尽管总体效果不显著。在低激活率的患者中可以看到最大的益处。

更新日期:2024-11-12
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