Estimated to exceed $160.5 billion (USD) by 2024, the electronic health (eHealth) market is a burgeoning area of healthcare that is designed to facilitate the delivery of healthcare services and information through the use of smartphones, tablets, laptops, and desktop computers.

Chronic kidney disease (CKD) patients have various healthcare needs, such as a complex diet and medication guidance. Were these to be managed more independently, it could improve quality of life and lower costs. While eHealth has the potential to enable CKD patients to take better care of themselves, little research has been done on these systems with respect to this disease.

 In the Cochrane Database of Systematic Reviews, a group of Australian researchers from the University of Sydney, in conjunction with several other medical centers and universities, assessed the benefits and drawbacks of eHealth systems against traditional healthcare for chronic kidney disease (CKD) patients.* Randomized controlled clinical trials and semi-clinical trials on the subject were evaluated through January 14, 2019.

What they found

• The authors identified 43 studies with 6,617 participants in which eHealth was compared with traditional patient care methods.
• Of these studies, 39 consisted of mostly adult CKD patients, with 37% of the studies done on patients undergoing dialysis, 26% on patients in the pre-dialysis stage, and 35% on transplant recipients.
• Six eHealth modalities were found: telehealth, phone and tablet apps, text and email, electronic monitors, websites, and video or DVD.
• These six systems were further broken down into six intervention types: self-monitoring, educational, behavioral counseling, reminder systems, clinical decision aid, and mixed intervention.
• Results were classified as either clinical endpoints, blood pressure, dietary intake, biochemical parameters, quality of life, cost-effectiveness, medication adherence, behavior, or physical activity.

Unclear benefits

The authors concluded that the current eHealth system might improve the management of a minimal amount of data, such as with dietary sodium intake and fluid management. Overall, however, evidence for the use of eHealth systems for CKD is of low quality.

The authors are uncertain as to whether eHealth improves patient outcomes. The data is often unclear due to limitations in study methods and the high variability of eHealth modalities and intervention types. 

For a clearer picture of eHealth’s potential benefits,  “We need large and good quality research studies,” stated the authors.

*Stevenson, J.K.; Campbell, Z.C.; Webster, A.C.; et al. (2019, Aug. 6). “eHealth interventions for people with chronic kidney disease.” Cochrane Database of Systematic Reviews.