Smartphone app improves medication safety practices for patients with kidney disease
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A smartphone app targeting specific “self-care behaviors,” primarily medication management, increased patient engagement and reduced medication discrepancies for patients with chronic kidney disease.
“Improving medication safety and reducing the burden of [adverse drug reactions] ADRs are high priorities worldwide, as many are preventable,” Stephanie W. Ong, BScPhm, MSc, of the University Health Network, Mount Sinai Hospital, and colleagues wrote. “In CKD patients, it is estimated that 32% of serious ADRs are likely or potentially preventable. However, past community-based preventive programs for CKD patients showed little benefit, signaling the need for new approaches to optimize medication management.”
Suggesting one approach to improving medication safety is the development of “a process to identify and resolve medication discrepancies” (termed medication reconciliation), the researchers randomized 182 patients with CKD to one of two smartphone apps. The intervention group utilized eKidneyCare, an app that prompts patients to review medication changes or problems on a monthly basis and report these changes to clinicians; the app was also “automatically synchronized with the clinic pharmacy database.” The app utilized by the comparator group, on the other hand, requires patients to manually enter data and only stores medication information.
To test the efficacy of the intervention, researchers determined the rate of medication discrepancy for each group, which they defined as “differences between the patient’s reported history and the clinic’s medication record.”
In a related press release, Alexander G. Logan, MD, FRCP(C), co-investigator on the study, elaborated on the rationale behind conducting the research.
“We hypothesized that by promoting a sense of self-control and confidence in managing their condition, this would translate into increased patient safety,” Logan said.
Researchers found eKidneyCare performed better than the comparator, with results showing the eKidneyCare group had fewer total medication discrepancies (median 0.45 vs. 0.67). eKidneyCare use also appeared to reduce the severity of “all clinically relevant medication discrepancies,” which included those that the researchers classified as having the potential to cause “serious harm.”
Further, patients more actively used eKidneyCare than those in the comparator group, with usage data showing 72% of these patients completed one or more medication review per month; in contrast, 30% of patients in the comparator group kept their medication profile on their phone.
The researchers concluded by highlighting the increased utility of the app during the pandemic.
“eKidneyCare also captures the trend towards increased home management of chronic conditions, now spurred by the COVID-19 pandemic, and demonstrates the feasibility of conducting medication reconciliation without the necessity of face-to-face interviews,” they wrote. “The severe restrictions on in-person clinical visits [have] accelerated adoption of technologies that enhance home care and integrate medical information. eKidneyCare is perfectly placed to take advantage of these changes by offering patients an effective digital health tool that supports the self-management of many facets of kidney care.”
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