Remote usability testing and satisfaction with a mobile health medication inquiry system in CKD

Journal: Clinical Journal of the American Society of Nephrology

Manuscript ID: CJASN-1259-12-14.R2


Background and objectives: Inappropriate medication use is common in the care of patients with chronic kidney disease (CKD). We examined the feasibility of a simple mobile health tool designed to advise patients on safe medication usage in CKD. Design, setting, participants and measurements: Participants with pre-dialysis CKD (defined as an estimated glomerular filtration rate <60mL/min/1.73m2) in the Safe Kidney Care SKC) cohort study were recruited for home usability testing of a novel medication inquiry system (MIS) between January and September 2013. Testing was via two mobile platforms: 1) short messaging service (SMS) text, or 2) personal digital assistant (PDA; e.g. iPod Touch™). Twenty participants (half assigned to one device and half to the other) were enrolled and received an in-center tutorial on device usage prior to the end of the study visit. Participants were subsequently mailed 3 sample pill bottles with the name of randomly selected medications and asked to input these medications into the MIS. The MIS response options were as follows:
1) Safe in chronic kidney disease, 2) Not safe in chronic kidney disease, 3) Use with caution, speak with your healthcare provider, or 4) An error message (for an incorrectly inputted medication). Participants were asked to record the response issued by the MIS for each medication sent for usability testing. A user satisfaction survey was administered after completion of protocol.


All participants owned a mobile phone, but few owned a smartphone. Of 60 total medication queries, there were only 3 recorded errors, 2 of which occurred in the MS texting group. Overall satisfaction with the application was high, with slightly higher satisfaction noted in the PDA group compared to the SMS group.


The mobile health MIS application had general ease of use and high acceptance across two platforms among individuals representative of the CKD population. Tailored mobile health technology may improve medication safety in CKD.

Manuscript No. CJASN-1259-12-14.R2 – Diamantidis et al

Drug-Drug Interaction Inquiry System for Kidney Transplant Patients

Journal: Transplantation

Manuscript ID: TPA-2013-1271


Background and objectives:
Kidney transplant recipients are at increased risk for adverse safety events related to reduced renal function and polypharmacy. Health information technology (HIT) tools have a precautionary role in improving safety in patients with kidney transplants who treat risk of drug-drug interactions.

Design, participants and measurements:

Usability testing of a Drug-Drug Interaction Inquiry System on a representative sample of kidney transplant patients and their family members was conducted between January-April 2013, by a single interviewer. Each participant was provided with 35 tasks to complete on a mobile phone with a manual key pad. The tasks were classified according to how it was completed: easily completed / non-critical error, or critical error (where a participant was unable to complete the given task without intervention by the interviewer). The final task was timed using a stop watch.


Out of a total of 16 volunteers, 15 completed the testing. The median time to complete the final task was 4 minutes (range 2-9 minutes). In a cumulative total of 525 tasks, 33 critical errors were noted. Twelve participants had greater than or equal to one critical error.

Usability of a Drug Drug Interaction_Submitted_112113

Electronic Medication Inquiry System for CKD Patients

Journal: American Journal of Kidney Disease (AJKD)


Medication errors are a concern for patients with non–dialysis-dependent chronic kidney disease (CKD) because medications commonly used in CKD often require dose adjustment or potentially can cause nephrotoxicity.1 Information technology offers tools with the potential to reduce medication errors. Although cellular telephones, mobile devices, and computers have become ubiquitous in the United States, it is unknown to what extent patients from the CKD population have access to them or are proficient in their use because they frequently are older and of lower socioeconomic status and health literacy.2, 3, 4 In this study, we evaluated the usability of a medication inquiry system prototype offering patients information about the safety of drugs in CKD, designed for implementation across multiple technology platforms: (1) mobile device with text (short message service [SMS]) capability, (2) personal digital assistant (PDA), and (3) web site.

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Electronic Medication Inquiry System for CKD Patients