Study finds dietary apps for patients with CKD are limited in quantity, quality
After searching the Apple App Store and the Google Play Store for all mobile applications focused on dietary management in patients with chronic kidney disease, researchers determined the “few” that exist have important limitations.
Thus, Carl R. Russell III, of the college of engineering at Purdue University in Indiana, and colleagues, contended that work is needed to design improved applications that address the “unmet need[s]” of this patient population.
Potential of CKD diet apps
“Internet-based applications offer the possibility of achieving [the] goals [put forth by the 2020 Kidney Disease Quality Outcomes Initiative Clinical Practice Guideline for Nutrition in CKD] in ways that were not previously available by allowing individuals to easily access food and nutrition databases, count calories, track intake of macronutrients and micronutrients, and follow weight and other indices of nutrition. An ideal app would also allow physicians or registered dietitians secured access to these data if desired. Such an app would be able to help achieve the goals of enhancing both the health care experience and a patient's health.
The aims of this study were to identify existing CKD diet apps, determine how well these apps fulfilled the criteria of an ideal app, and perform a systematic literature review to assess the quality of such apps and more generally the state of CKD dietary or related apps. We performed our analysis with an eye to determining whether current apps adequately fulfill the needs of the CKD population or whether additional work is needed in this area.”
For the initial search, a team of reviewers utilized the following keywords and phrases: CKD, kidney nutrition, diet CKD, diet kidney, nutrition tracker CKD, CKD nutrition, chronic renal failure, CKD, dialysis and dialysis diet. From this search, 3,204 apps were identified but only 10 were included in the analysis based on meeting the following criteria: CKD diet-related, in English; patient-oriented; updated after 2010; and available for download through a major app source or published on in a journal.
Criteria for an ‘ideal’ app
“Each app was [then] evaluated for the presence of ideal characteristics,” the researchers wrote. “The app was checked for any purchase cost; availability on Google Play Store and Apple App Store; whether it references any guidelines or sources; if the app was designed for patients with CKD; if it was able to store patient data; if it allowed patients to track their own nutrient intake; if the app provided recipes to the patient; if the data the patient stored could be shared with a clinician; if the app allowed recommendations to be personalized based on CKD stage; and if the app allowed further modifications to accommodate personalized dietary recommendations.”
Results suggested that of the 10 apps, eight were designed exclusively for dietary management in CKD, seven were free of charge, five included CKD-friendly recipes, four included personalized recommendations based on data supplied by the patient, and four tracked macronutrient and micronutrient intake and provided specific nutritional recommendations; two were available in both the Apple App Store and the Google Play Store and just one offered an option to share health information.
Russell and colleagues highlighted that none of the apps “used the most contemporary nutrition guidelines on which to base their recommendations” (specifically, the 2020 KDOQI nutrition guideline).
Further, the researchers found the apps were “difficult to use” and often required a high e-literacy level, while also lacking adequate security features.
“Content is not the only important aspect of a CKD diet app. Careful consideration should also go into its software design,” the researchers wrote. “Access on several platforms is important for increased accessibility. The option of sharing and storing data with physicians, dietitians, or other health care providers could lead to more collaborative patient care.
In fact, ensuring that physicians, dieticians, and patients all play a role in the development of a new app will be critical in ensuring its optimal design.”