Effects of mHealth on kidney disease knowledge, stress management and adherence to treatment among hemodialysis patients in selected regions of Kenya

Abstract

Background: Chronic kidney disease (CKD) is a significant global health issue, causing over 1.1 million deaths annually, with prevalence rates especially high in Sub-Saharan Africa. Despite governmental efforts to provide hemodialysis treatment in places like Kenya, challenges such as late diagnoses, low public awareness, and a systemic shortage of healthcare workers persist. mHealth interventions, which have shown promise in over 30 low- and middle-income countries, offer a potential solution to enhance treatment adherence and improve self-care, although more research is needed to validate their efficacy compared to traditional educational methods. Methods: This quasi-experimental study assessed mHealth interventions on hemodialysis patients in Kenya, targeting knowledge, treatment adherence, and psychosocial support. 132 adults participated from April 2021 to January 2023. The treatment group got mobile messaging for nine months; controls didn't. Data, gathered via questionnaires, was analyzed with Open Data Kit and statistical package for the social sciences (SPSS), maintaining ethical standards. Results: The mHealth intervention study found no sociodemographic differences between groups, ensuring validity. Knowledge on kidney disease significantly increased in the intervention group by 68.6% compared to 2.3% in the control group. Medication adherence significantly improved (p<0.001), as did hemodialysis session attendance. Dietary compliance rates equalized over time. Depression levels significantly improved in the intervention group (p=0.001), while initial anxiety favored the control group but worsened (p=0.006). Overall, the intervention was effective in improving knowledge, treatment adherence, and mental health. Conclusions: The study validated the effectiveness of mHealth in enhancing knowledge on kidney diseases, improving medication and treatment adherence, and reducing depression among hemodialysis patients.