SUN-314 EXISTING RENAL DIET APPLICATIONS HAVE LIMITED USABILITY FOR CKD PATIENTS: A CONTENT ANALYSIS IN MALAYSIA CONTEXT

Abstract

With the unprecedented growth of mobile technology, a plethora of renal diet applications (apps) have been developed to promote patient’s self-management. Nevertheless, the usability of these apps remain questionable. This study was aimed to evaluate the contents and feature of the existing renal diet apps in Malaysia context. Content analysis of the existing renal diet apps in Google Play and Apple App stores was performed. Apps were identified using English and Malay keywords “kidney diet” and “makanan sakit buah pinggang”. Inclusion criteria included free and paid apps that were available in English or Malay language and provide nutrition information for adult renal patients. On contrary, apps were excluded if they were not meant for patient’s self-management, redundant or could not be installed due to password protection. Eligible apps were evaluated by 2 trained research assistants with a good inter-rater reliability, (intra-class coefficient, ICC = 0.762) based on a 100-point scale. Evaluating aspects included the operating language (sub-score=1), food database (sub-score=2), presence of 12 selected valuable features (sub-score=12), extent of incorporating health behaviour theory based on 12 theoretical constructs (sub-score=60) and technical quality of the apps (sub-score=25) using Mobile Application Rating Scale (MARS). App scores were expressed as mean ± standard deviation. A total of 22 (7.9%) out of 277 apps were eligible for evaluation. Of the 22 eligible apps, 72.7% (n=16) were downloaded from Google Play stores while the remaining 27.3% (n=6) were available in Apple App store. On the basis of 100-point score, the mean overall score of the existing renal diet apps was only 30.12 ± 13.77. Majority of the apps (86.4%) scored less than 50 (per 100 score), with 51.4 and 10.3 being the highest and lowest score respectively. All of the apps were available only in English language and none of the app contained Malaysian food database. The mean score for the aspect of valuable features was 3.34 ± 1.71 (per 12 score). The 3 most popular features found in the commercial renal diet apps were general education (72.7%), free download (68.2%) followed by easy to use (54.5%). While the mean score for health behaviour constructs was 13.41 ± 11.56 (per 60 score) in which knowledge was the most common theoretical construct incorporated. In last, the overall app technical quality was poor (mean overall score of MARS= 13.44 ± 2.07). Although most of the existing renal diet apps were available for free and easy to use, they were theory deficient and provided only general renal nutrition knowledge rather than individualized education. In addition, the absence of Malay language and local food database in these apps may limit their usability for Malaysian CKD patients. Thus, there is a need to develop a theory and population-based renal diet app that provides individualised education to support self-management for Malaysian CKD patients.