Study of Self-monitoring of Weight & Blood Pressure (Via patientMpower Platform) in Hemodialysis

Not Applicable

Completed

Conditions: Renal Dialysis

Interventions: Other: patientMpower application
Other: sham application

Registration Number: NCT03403491

Lead Sponsor: patientMpower Ltd.

Brief Summary: Pilot-scale study to assess the effect of self-monitoring using the patientMpower electronic health journal (pMp app) \[+digital weighing scales \& BP monitor\] on outcomes in ambulatory haemodialysis patients. Design: prospective, open-label, random order, sham-controlled, two-period crossover comparison of the pMp app \[+digital weighing scales \& BP monitor\] compared with a sham application (without weighing scales or BP monitor). Duration: 10 weeks (usual care run-in for 2 weeks followed by 2 x 4 observation periods).

Primary objective is to determine the frequency of use of the pMp app \[+digital weighing scales \& BP monitor\] in patients randomized to that observation method. Additional objectives are to determine the effect of pMp app \[+digital weighing scales \& BP monitor\] on proportion of haemodialysis sessions in which ultrafiltration rate is ≤ 10 mL/kg/h and in which interdialytic weight gain (IDWG) is ≤ 4% and effect of pMp on pre-dialysis weight and BP, medication adherence, compliance with daily recording (of fluid intake, weight, BP) and requirement for additional unscheduled dialysis.

An additional objective is to assess the acceptability and utility of the pMp app in helping hemodialysis patients and their healthcare professional caregivers manage their condition (assessed from both patient and healthcare professional perspective).

Detailed Description: Pilot-scale, prospective, open-label, randomized, two-period, cross-over intervention study.

Each patient will be randomized to one of the two possible observation sequences:

Sequence 1: run-in (2 weeks): usual care followed by period 1 (4 weeks): patientMpower application (+digital weighing scales \& BP monitor) followed by period 2 (4 weeks): sham application

OR

Sequence 2: run-in (2 weeks): followed by period 1 (4 weeks) sham application followed by period 2 (4 weeks): patientMpower application (+digital weighing scales \& BP monitor)

The study will not make any other changes to the therapeutic interventions offered to the patients. Patients will follow their usual care and hemodialysis programme throughout the study.

Proposed sample size is approximately 50 patients.

Patients will be recruited through three haemodialysis facilities under the governance of Beaumont Hospital, a tertiary care centre for nephrology in Dublin, Ireland.

The study observational intervention is an electronic health journal, the patientMpower application (with a supplied digital weighing scales and BP monitor). This has been developed specifically for patients undergoing hemodialysis. The app is an electronic application downloaded to the patient's mobile phone or tablet device. The app is designed to allow the patient to report various parameters relevant to hemodialysis and record these on a regular basis, ideally daily. The information recorded by the patients will be stored in a secure cloud system and will be available to the patient through their phone or mobile device at all times. No personal health data are stored on the phone or mobile device itself.

Patient-reported measures (at a minimum) will include body weight (at least one reading /day), BP and compliance with relevant medication. Additional patient-reported measures which can be reported on the patientMpower app include body temperature, activity levels and symptoms.

The control observation will be usual care with a sham electronic application (which will not allow recording of body weight, BP or other measurements).

The objective of this pilot-scale cross-over open label randomized study is to assess the effect of self-monitoring using the patientMpower electronic health journal \[+digital weighing scales \&BP monitor\] on outcomes in ambulatory hemodialysis patients.The primary objective will be to determine the frequency of use of the patientMpower app (+digital weighing scales \& BP monitor).

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 43

Inclusion Criteria

Not provided

Exclusion Criteria

Significant confusion or any concomitant medical condition, which would limit the ability of the patient to record symptoms or other parameters on an electronic health journal

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Sequence 1	patientMpower application	Usual care for 2 weeks followed by using patientMpower application \[+digital weighing scales \& BP monitor\] for 4 weeks followed by sham application (without digital scales or BP monitor) for 4 weeks.
Sequence 1	sham application	Usual care for 2 weeks followed by using patientMpower application \[+digital weighing scales \& BP monitor\] for 4 weeks followed by sham application (without digital scales or BP monitor) for 4 weeks.
Sequence 2	sham application	Usual care for 2 weeks followed by sham application (without digital scales or BP monitor) for 4 weeks followed by using patientMpower application \[+digital weighing scales \& BP monitor\] for 4 weeks.
Sequence 2	patientMpower application	Usual care for 2 weeks followed by sham application (without digital scales or BP monitor) for 4 weeks followed by using patientMpower application \[+digital weighing scales \& BP monitor\] for 4 weeks.

Primary Outcome Measures

Name	Time	Method
Patient Engagement With patientMpower App to Record Body Weight	28 days	Actual number of days body weight reported by patient on patientMpower app

Secondary Outcome Measures

Name	Time	Method
Effect of patientMpower App [+Digital Scales & BP Monitor] on Ultrafiltration Rate (Proportion </= 10mL/kg/h)	28 days	Proportion of hemodialysis sessions in which ultrafiltration rate is less than/equals 10mL/kg/h
Effect of patientMpower App [+Digital Scales & BP Monitor] on Pre-dialysis Inferior Vena Cava Longitudinal Diameter	28 days	longitudinal diameter
Effect of patientMpower App [+Digital Scales & BP Monitor] on Interdialytic Weight Gain (Relative to Dry Weight)	28 days	Average interdialytic weight gain as percentage of patient's dry weight
Effect of patientMpower App [+Digital Scales & BP Monitor] on Interdialytic Weight Gain (Absolute)	28 days	Average interdialytic weight gain in kg
Effect of patientMpower App [+Digital Scales & BP Monitor] on Interdialytic Weight Gain (Proportion </= 4%)	28 days	Proportion of hemodialysis sessions in which interdialytic weight gain is less than/equals 4%
Effect of patientMpower App [+Digital Scales & BP Monitor] on Predialysis Weight	28 days	predialysis weight
Effect of patientMpower App [+Digital Scales & BP Monitor] on Pre-dialysis Systolic Blood Pressure	28 days	pre-dialysis supine systolic blood pressure
Effect of patientMpower App [+Digital Scales & BP Monitor] on Pre-dialysis Diastolic Blood Pressure	28 days	pre-dialysis supine diastolic blood pressure
Patient Engagement With patientMpower App to Record Medication Adherence	28 days	actual number of days medication adherence reported by patient on patientMpower app
Patient Engagement With patientMpower App to Record Blood Pressure.	28 days	actual number of days blood pressure reported by patient on patientMpower app
Patient Engagement With patientMpower App to Record Symptoms	28 days	Actual number of days symptoms reported by patient on patientMpower application
Patient Engagement With patientMpower App to Record Fluid Intake	28 days	Actual number of days fluid intake reported by patients on patientMpower application
Effect of patientMpower App [+Digital Scales & BP Monitor] on Requirement for Additional Unscheduled Hemodialysis.	28 days	number of patients requiring additional unscheduled hemodialysis sessions
Patient Opinion on Utility and Acceptability of patientMpower Application	28 days	Questionnaire-based assessment: 7 questions. \[pMp = patientMpower intervention\] 1. using pMp helped me to take correct dose of my medicines every day 2. using pMp gave me more confidence/greater sense of control in managing my health 3. my preference for using pMp 4. my difficulty rating in using pMp 5. effect of using pMp on my well-being and daily life 6. do I want to continue using pMp after study end 7. did I like using pMp Possible responses Q1, Q2: strongly agree/agree/disagree/strongly disagree; Q3: yes/no preference/no; Q4: very easy/easy/difficult/very difficult; Q5: positive/negative; Q6: yes/no; Q7: 10-point linear scale: 1 (did not like at all) to 10 (liked a lot)
Effect of patientMpower App [+Digital Scales & BP Monitor] on Pre-dialysis Inferior Vena Cava Collapsibility	28 days	number of patients with at least 50% collapsibility
Effect of patientMpower App [+Digital Scales & BP Monitor] on Pre-dialysis Inferior Vena Cava Transverse Diameter	28 days	transverse diameter