Background
There is limited research of electronic tools for self-management for patients with chronic kidney disease (CKD). We sought to evaluate participant engagement, perceived self-efficacy and website usage in a preliminary evaluation of My Kidneys My Health, a patient-facing eHealth tool in Canada.

Methods
We conducted an explanatory sequential mixed-methods study of adults with CKD who were not on kidney replacement therapy and who had access to My Kidneys My Health for 8 weeks. Outcomes included acceptance (measured by the Technology Acceptance Model), self-efficacy (measured by the Chronic Disease Self-Efficacy Scale [CDSES]) and website usage patterns (captured using Google Analytics). We analyzed participant interviews using qualitative content analysis.

Results
Twenty-nine participants with CKD completed baseline questionnaires, of whom 22 completed end-of-study questionnaires; data saturation was achieved with 15 telephone interviews. Acceptance was high, with more than 70% of participants agreeing or strongly agreeing that the website was easy to use and useful. Of the 22 who completed end-of-study questionnaires, 18 (82%) indicated they would recommend its use to others and 16 (73%) stated they would use the website in the future. Average scores for website satisfaction and look and feel were 7.7 (standard deviation [SD] 2.0) and 8.2 (SD 2.0) out of 10, respectively. The CDSES indicated that participants gained an increase in CKD information. Interviewed participants reported that the website offered valuable information and interactive tools for patients with early or newly diagnosed CKD, or for those experiencing changes in health status. Popular website pages and interactive features included Food and Diet, What is CKD, My Question List and the Depression Screener.

Interpretation
Participants indicated that the My Kidneys My Health website provided accessible content and tools that may improve self-efficacy and support in CKD self-management. Further evaluation of the website’s effectiveness in supporting self-management among a larger, more heterogenous population is warranted.

Chronic kidney disease (CKD) affects about 9% of adults in Canada.1 It is a progressive condition; 14.6% of patients with mild CKD and 16.5% with moderate CKD progress to end-stage CKD (i.e., category 5, approaching the need for or receiving kidney replacement therapy).2 Slowing the progression of CKD is a priority for patients and those who care for them,3,4 and entails lifestyle modifications, as well as medical management of relevant comorbidities.5,6

Self-management support can delay disease progression and improve quality of life for people with CKD by increasing their knowledge, skills and confidence to cope with all aspects of illness.7–9 Our previous work identified and prioritized the self-management needs of patients with CKD10,11 and informed the codevelopment of a Web-based tool to support self-management, My Kidneys My Health (MKMH) (https://mykidneysmyhealth.com/).12 Although numerous websites are available to support patients with CKD, most lack comprehensive, tailored content for patient self-management.13 In this study, we sought to assess patient engagement with MKMH, specifically the acceptability of the website, its impact on perceived self-efficacy and potential factors related to implementation and usefulness of a patient-facing eHealth tool.

Donald M, Beanlands H, Straus S, Smekal M, Gil S, Elliott MJ, Harwood L, Waldvogel B, Delgado M, Sparkes D, Tong A, Grill A, Novak M, James MT, Brimble KS, Tu K, Hemmelgarn BR

CMAJ Open

Published 2022

Research Project: Self-Management