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.