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Q)It seems that at every conference I attend, a tech/marketing rep stands up to rave about “this” app or “that” online program. My average patient is older than 60 (physiologically 80), has vision issues related to diabetes, hypertension, or cataracts, can’t afford a smartphone, wouldn’t know an app from a nap, and has trouble just managing to eat correctly. What makes these reps think that patients can use technology?
We are often encouraged to incorporate technology into our daily interactions with patients. Meaningful use has us signing up 70-year-old patients for our practice’s patient portal and counting on them to write a message to us so we can receive credit. Our initial response is to groan and ask if the government knows what kind of patients we see.
However, a new article in the Clinical Journal of the American Society of Nephrology suggests that our patients may be more tech savvy than we think.1 The study found that patients with chronic kidney disease (CKD) not only know how to use a smartphone application but also find its implementation useful.
Patients included in the study were, on average, 59 and had stage IV to stage V CKD and an estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m2. The study assessed knowledge of blood pressure, medications, CKD-related symptoms, and CKD-related laboratory tests.
Although 60% of the study cohort had never used a smartphone before, monthly adherence rates were higher than 80%. Outcomes included a statistically significant reduction in blood pressure, which was attributed to patients’ ability to better monitor their health and reduce their anxiety. The smartphone data sets also helped to identify cases of masked hypertension and more than 100 medication errors, 60% of which required intervention. Subsequent visits with providers were found to be more useful as a result, since both patients and providers had better quality information.
An accompanying editorial cautioned, however, that despite these positive findings, we must be mindful that smartphone ownership is less common among lower income patients. Fifty percent of those making less than $30,000 per year own a smartphone, compared with 84% of patients with an annual income of $75,000 or more.2 CKD patients are of varying socioeconomic status, with lower eGFR often corresponding to lower socioeconomic status.
So while medical apps have a future with CKD (and by implication, all) patients, they are not unlike much else in medicine: We must tailor our practice to meet the needs of our patient population. These findings are encouraging for use of smartphone technology, but it is not a “one size fits all” solution. —SM
Sherry Mathes, NP-C
Georgia Nephrology LLC, Lawrenceville, Georgia
1. Ong SW, Jassal SV, Miller JA, et al. Integrating a smartphone-based self-management system into usual care of advanced CKD. Clin J Am Soc Nephrol. 2016;11(6):1054-1062.
2. Desai T, Yee J, Soman S. Smartphone apps: a patient’s new best friend? Clin J Am Soc Nephrol. 2016;11(6):935-937.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation’s Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month’s responses were authored by Sherry Mathes, NP-C, who practices at Georgia Nephrology LLC in Lawrenceville, Georgia, and Cynthia Smith, DNP, CNN-NP, FNP-BC, APRN, who practices with Renal Consultants PLLC in South Charleston, West Virginia.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation’s Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month’s responses were authored by Sherry Mathes, NP-C, who practices at Georgia Nephrology LLC in Lawrenceville, Georgia, and Cynthia Smith, DNP, CNN-NP, FNP-BC, APRN, who practices with Renal Consultants PLLC in South Charleston, West Virginia.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation’s Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month’s responses were authored by Sherry Mathes, NP-C, who practices at Georgia Nephrology LLC in Lawrenceville, Georgia, and Cynthia Smith, DNP, CNN-NP, FNP-BC, APRN, who practices with Renal Consultants PLLC in South Charleston, West Virginia.
Q)It seems that at every conference I attend, a tech/marketing rep stands up to rave about “this” app or “that” online program. My average patient is older than 60 (physiologically 80), has vision issues related to diabetes, hypertension, or cataracts, can’t afford a smartphone, wouldn’t know an app from a nap, and has trouble just managing to eat correctly. What makes these reps think that patients can use technology?
We are often encouraged to incorporate technology into our daily interactions with patients. Meaningful use has us signing up 70-year-old patients for our practice’s patient portal and counting on them to write a message to us so we can receive credit. Our initial response is to groan and ask if the government knows what kind of patients we see.
However, a new article in the Clinical Journal of the American Society of Nephrology suggests that our patients may be more tech savvy than we think.1 The study found that patients with chronic kidney disease (CKD) not only know how to use a smartphone application but also find its implementation useful.
Patients included in the study were, on average, 59 and had stage IV to stage V CKD and an estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m2. The study assessed knowledge of blood pressure, medications, CKD-related symptoms, and CKD-related laboratory tests.
Although 60% of the study cohort had never used a smartphone before, monthly adherence rates were higher than 80%. Outcomes included a statistically significant reduction in blood pressure, which was attributed to patients’ ability to better monitor their health and reduce their anxiety. The smartphone data sets also helped to identify cases of masked hypertension and more than 100 medication errors, 60% of which required intervention. Subsequent visits with providers were found to be more useful as a result, since both patients and providers had better quality information.
An accompanying editorial cautioned, however, that despite these positive findings, we must be mindful that smartphone ownership is less common among lower income patients. Fifty percent of those making less than $30,000 per year own a smartphone, compared with 84% of patients with an annual income of $75,000 or more.2 CKD patients are of varying socioeconomic status, with lower eGFR often corresponding to lower socioeconomic status.
So while medical apps have a future with CKD (and by implication, all) patients, they are not unlike much else in medicine: We must tailor our practice to meet the needs of our patient population. These findings are encouraging for use of smartphone technology, but it is not a “one size fits all” solution. —SM
Sherry Mathes, NP-C
Georgia Nephrology LLC, Lawrenceville, Georgia
Q)It seems that at every conference I attend, a tech/marketing rep stands up to rave about “this” app or “that” online program. My average patient is older than 60 (physiologically 80), has vision issues related to diabetes, hypertension, or cataracts, can’t afford a smartphone, wouldn’t know an app from a nap, and has trouble just managing to eat correctly. What makes these reps think that patients can use technology?
We are often encouraged to incorporate technology into our daily interactions with patients. Meaningful use has us signing up 70-year-old patients for our practice’s patient portal and counting on them to write a message to us so we can receive credit. Our initial response is to groan and ask if the government knows what kind of patients we see.
However, a new article in the Clinical Journal of the American Society of Nephrology suggests that our patients may be more tech savvy than we think.1 The study found that patients with chronic kidney disease (CKD) not only know how to use a smartphone application but also find its implementation useful.
Patients included in the study were, on average, 59 and had stage IV to stage V CKD and an estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m2. The study assessed knowledge of blood pressure, medications, CKD-related symptoms, and CKD-related laboratory tests.
Although 60% of the study cohort had never used a smartphone before, monthly adherence rates were higher than 80%. Outcomes included a statistically significant reduction in blood pressure, which was attributed to patients’ ability to better monitor their health and reduce their anxiety. The smartphone data sets also helped to identify cases of masked hypertension and more than 100 medication errors, 60% of which required intervention. Subsequent visits with providers were found to be more useful as a result, since both patients and providers had better quality information.
An accompanying editorial cautioned, however, that despite these positive findings, we must be mindful that smartphone ownership is less common among lower income patients. Fifty percent of those making less than $30,000 per year own a smartphone, compared with 84% of patients with an annual income of $75,000 or more.2 CKD patients are of varying socioeconomic status, with lower eGFR often corresponding to lower socioeconomic status.
So while medical apps have a future with CKD (and by implication, all) patients, they are not unlike much else in medicine: We must tailor our practice to meet the needs of our patient population. These findings are encouraging for use of smartphone technology, but it is not a “one size fits all” solution. —SM
Sherry Mathes, NP-C
Georgia Nephrology LLC, Lawrenceville, Georgia
1. Ong SW, Jassal SV, Miller JA, et al. Integrating a smartphone-based self-management system into usual care of advanced CKD. Clin J Am Soc Nephrol. 2016;11(6):1054-1062.
2. Desai T, Yee J, Soman S. Smartphone apps: a patient’s new best friend? Clin J Am Soc Nephrol. 2016;11(6):935-937.
1. Ong SW, Jassal SV, Miller JA, et al. Integrating a smartphone-based self-management system into usual care of advanced CKD. Clin J Am Soc Nephrol. 2016;11(6):1054-1062.
2. Desai T, Yee J, Soman S. Smartphone apps: a patient’s new best friend? Clin J Am Soc Nephrol. 2016;11(6):935-937.