Effects of mHealth on kidney disease knowledge, stress management and adherence to treatment among hemodialysis patients in selected regions of Kenya

Josphat M. Muchangi; John K. Gachuki; George Kimathi

doi:10.18203/2394-6040.ijcmph20233146

Authors

Josphat M. Muchangi Mount Kenya University, School of Public Health, Thika, Kenya https://orcid.org/0000-0002-7210-4082
John K. Gachuki Mount Kenya University, School of Public Health, Thika, Kenya
George Kimathi Amref International University, School of Public Health, Nairobi, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20233146

Keywords:

mHealth, Hemodialysis, Knowledge, Adherence, Depression, Anxiety

Abstract

Background: Chronic kidney disease (CKD) is a significant global health issue, causing over 1.1 million deaths annually, with prevalence rates especially high in Sub-Saharan Africa. Despite governmental efforts to provide hemodialysis treatment in places like Kenya, challenges such as late diagnoses, low public awareness, and a systemic shortage of healthcare workers persist. mHealth interventions, which have shown promise in over 30 low- and middle-income countries, offer a potential solution to enhance treatment adherence and improve self-care, although more research is needed to validate their efficacy compared to traditional educational methods.

Methods: This quasi-experimental study assessed mHealth interventions on hemodialysis patients in Kenya, targeting knowledge, treatment adherence, and psychosocial support. 132 adults participated from April 2021 to January 2023. The treatment group got mobile messaging for nine months; controls didn't. Data, gathered via questionnaires, was analyzed with Open Data Kit and statistical package for the social sciences (SPSS), maintaining ethical standards.

Results: The mHealth intervention study found no sociodemographic differences between groups, ensuring validity. Knowledge on kidney disease significantly increased in the intervention group by 68.6% compared to 2.3% in the control group. Medication adherence significantly improved (p<0.001), as did hemodialysis session attendance. Dietary compliance rates equalized over time. Depression levels significantly improved in the intervention group (p=0.001), while initial anxiety favored the control group but worsened (p=0.006). Overall, the intervention was effective in improving knowledge, treatment adherence, and mental health.

Conclusions: The study validated the effectiveness of mHealth in enhancing knowledge on kidney diseases, improving medication and treatment adherence, and reducing depression among hemodialysis patients.

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References

GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-544.

Perico N, Remuzzi G. Chronic kidney disease in sub-Saharan Africa: A public health priority. Lancet Glob Heal. 2014;2(3):124-5.

George C, Mogueo A, Okpechi I, Echouffo-Tcheugui JB, Kengne AP. Chronic kidney disease in low-income to middle-income countries: The case f increased screening. BMJ Glob Heal. 2017;2(2):1-10.

Chege P. Multiple cardiovascular disease risk factors in rural Kenya: evidence from a health and demographic surveillance system using the WHO STEP-wise approach to chronic disease risk factor surveillance. South African Fam Pract. 2016;58(2):54-61.

EKN. Kenya Health Sector - Opportunities for Dutch Life Scienec & Health Sector. 2016. Available at: https://www.rvo.nl/sites/default/files/2016/10/ 2016_Kenyan_Healthcare_Sector_Report_Compleet.pdf. Accessed on 09 September 2023.

World Health Organization (WHO). First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control. 28-29 April 2011 MOSCOW Declar. 2011;1-5. Available at: http://www.who.int/nmh/events/moscow_ncds_2011/conference_documents/en/. Accessed on 09 September 2023.

Chowdhury TA, Iqbal S, Talukder US, Ananna MA, Bhuiyan ASMMM, Billah M, et al. A study on knowledge of patients with end stage renal disease towards dialysis in a tertiary care hospital in Dhaka city. IMC J Med Sci. 2017;11(1):11-4.

Cassidy BP, Harwood L, Getchell LE, Smith M, Sibbald SL, Moist LM. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study. Can J Kidney Heal Dis. 2018;5.

Enoch R, Lobo J, Ghosh AK. A Study to Assess the Effectiveness of Structured Teaching Programme on Renal Diet on the Chronic Kidney Disease Patients Attending Tertiary Care Centre. Int J Med Res Health Sci. 2018;7(4):94-100.

Malongo IK, Nzuki DM. A Theoretical Review of Integration of Managed Equipment Services and Delivery of Healthcare Services. Int J Sci Res. 2016;5(12):479-83.

Kassebaum NJ, Arora M, Barber RM. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-58.

Ren Q, Shi S, Yan C, Liu Y, Han W, Lin M, et al. Self-Management Micro-Video Health Education Program for Hemodialysis Patients. Clin Nurs Res. 2022;31(6):1148-57.

Nielsen TM, Juhl MF, Feldt-Rasmussen B, Thomsen T. Adherence to medication in patients with chronic kidney disease: A systematic review of qualitative research. Clin Kidney J. 2018;11(4):513-27.

Wu YH, Hsu YJ, Tzeng WC. Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study. Int J Environ Res Public Health. 2022;19(2).

Goh ZS, Griva K. Anxiety and depression in patients with end-stage renal disease: Impact and management challenges – A narrative review. Int J Nephrol Renovasc Dis. 2018;11:93-102.

Ginieri-Coccossis M, Theofilou P, Synodinou C, Tomaras V, Soldatos C. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment. BMC Nephrol. 2008;9(1):1-9.

Sarker MHR, Moriyama M, Rashid HU, Rahman MM, Chisti MJ, Das SK, et al. Chronic Kidney Disease Awareness Campaign and Mobile Health Education to Improve Knowledge, Quality of Life, and Motivation for a Healthy Lifestyle Among Patients With Chronic Kidney Disease in Bangladesh: Randomized Controlled Trial. J Med Internet Res. 2022;24(8):e37314.

Feizalahazadeh H, Tafreshi MZ, Mogghaddasi H,. Effectiveness of multimedia based on education and traditional methods on life quality of hemodialysis patients. J Holist Nurs Midwifery. 2016;26(2):69-78.

Jayanti A, Foden P, Wearden A, Mitra S. Illness beliefs in end stage renal disease and associations with self-care modality choice. PLoS One. 2016;11(7):1-17.

Saadatifar B, Sharifi S, Faghihi H, Sadeghi Googhary N. Effect of mHealth Training on Treatment Adherence in Hemodialysis Patients. Medical-Surgical Nurs J. 2023;11(3).

Wilson J, Heinsch M, Betts D, Booth D, Kay-Lambkin F. Barriers and facilitators to the use of e-health by older adults: a scoping review. BMC Public Health. 2021;21(1):1-12.

Kumar R, Das A. The potential of mHealth as a game changer for the management of sickle cell disease in India. JMIR mHealth uHealth. 2021;9(4).

Flueckiger RM, Courtright P, Abdala M, Abdou A, Abdulnafea Z, Al-Khatib TK, et al. The global burden of trichiasis in 2016. PLoS Negl Trop Dis. 2019;13(11):e0007835.

Goldberg SB, Lam SU, Simonsson O, Torous J, Sun S. Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digit Heal. 2022;1(1):e0000002.

Linardon J, Cuijpers P, Carlbring P, Messer M, Fuller-Tyszkiewicz M. The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials. World Psychiatry. 2019;18(3):325-36.

Murtagh FEM, Addington-Hall J, Higginson IJ. The Prevalence of Symptoms in End-Stage Renal Disease: A Systematic Review. Adv Chronic Kidney Dis. 2007;14(1):82-99.

Cukor D, Coplan J, Brown C, Friedman S, Newville H, Safier M, et al. Anxiety Disorders in Adults Treated by Hemodialysis: A Single-Center Study. Am J Kidney Dis. 2008;52(1):128-36.

Parmentier T, Sienaert P. The use of triiodothyronine (T3) in the treatment of bipolar depression: A review of the literature. J Affect Disord. 2018;229:410-4.

Firth J, Torous J, Nicholas J. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017;16(3):287-98.

Som A, Groenendyk J, An T. Improving Dialysis Adherence for High Risk Patients Using Automated Messaging: Proof of Concept. Sci Rep. 2017;7(1):1-7.

Walsh CA, Cahir C, Tecklenborg S, Byrne C, Culbertson MA, Bennett KE. The association between medication non-adherence and adverse health outcomes in ageing populations: A systematic review and meta-analysis. Br J Clin Pharmacol. 2019;85(11):2464-78.

Torabi Khah M, Farsi Z, Sajadi SA. Comparing the effects of mHealth application based on micro-learning method and face-to-face training on treatment adherence and perception in haemodialysis patients: a randomised clinical trial. BMJ Open. 2023;13(6):e071982.

Garnett A, Northwood M, Ting J, Sangrar R. mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review. JMIR Aging. 2022;5(3):1-24.

Kreps GL. The relevance of health literacy to mHealth. Inf Serv Use. 2017;37(2):123-30.

Alaiad A, Alsharo M, Alnsour Y. The Determinants of M-Health Adoption in Developing Countries: An Empirical Investigation. Appl Clin Inform. 2019;10(5):820-40.