Smit-Ckd: A Mobile App to Improve Adherence to Therapy in Ckd Patients. A Pilot Study.

Chronic Kidney Disease is a major public health issue, with about 13% of the general adult population and 30% of the elderly affected. Patients in the last stage of this disease have an almost uniquely high risk of death and cardiovascular disease, probably because kidney and cardiovascular system share the same risk factors, such as hypertension, high blood glucose and body weight. Reduced adherence to therapy represents an additional risk factor for cardiovascular morbidity and mortality in renal patients. Considering the wide spreading of mobile phones, an app could be a possible solution to self-monitor cardiovascular risk factors and to improve adherence to therapyWe developed an integrated system made by a server and an app within the SMIT-CKD project, with the aim to improve self-monitoring of risk factors of both renal and cardiovascular disease and to improve adherence to therapy. The integrated system was tested with the help of 22 volunteers.The level of compliance with the use of the app and data entering was quite high, being 'malfunctioning due to obsolete versions of the operative system' the main cause of scarce use. After 6 months of use, the percentage of regular intake of medications rose from 64 to 82%. User satisfaction was high, as both the server and the app obtained high scores in the questionnaires administered to general practitioners and patientsOur pilot study demonstrated that the use of a simple Mobile APP may improve adherence to therapy in patients affected by Chronic Kidney Disease. Further studies, specifically designed to test this app in a larger population, are required to clarify if the use of the SMIT-CKD integrated system will have long-term effects on therapy adherence, and if self-monitoring of risk factors will improve clinical outcomes in this population.