WCN26-6293 CO-DESIGNING A MOBILE HEALTH APPLICATION TO IMPROVE ENGAGEMENT AND OUTCOMES IN DIALYSIS CARE: A MULTI-SITE EVALUATION IN SOUTH AFRICA

Introduction: Chronic kidney disease (CKD) and dialysis are increasing global public health burdens, requiring complex, lifelong care.Although mHealth apps have shown value in many components of care, more data is needed to assess mental health, quality of life (QOL) and impact on costs.This study, carried out in National Renal Care (NRC) dialysis units developed a mobile health (mHealth) application with patients to support their experience on dialysis.Its aimed was to evaluate its impact on patient engagement, self-management behaviours, clinical outcomes and health related quality of life (HRQoL).Methods: A mixed-methods study was conducted across 87 dialysis sites in South Africa, including 76 in-centre haemodialysis units and 11 home therapy programmes.A retrospective analysis of mobile app usage and clinical data was carried out from May 2022 to November 2024.The evaluation examined five domains: user engagement, user experience, clinical outcomes, health system integration, and adoption.Quantitative measures included app interaction, frequency, session duration and feature utilization.Clinical indicators assessed were haemoglobin, albumin, phosphate, calcium and dialysis adequacy levels (Kt/V).Patient reported outcomes were collected using the SF-36 HRQoL survey.Results: A total of 3,410 dialysis patients registered on the app, representing 95% adoption in the cohort.The mean age was 57.6 years, with 60.5% male and 39.5% female.The average patient engagement score was 58.5%, with a mean session duration of 18.4 minutes.Frequently accessed features included renal-friendly recipes (24.7%), educational articles (24.7%), clinical results (16.8%) and symptom tracking (12.5%).High app users (>4 logins/month) demonstrated modest improvement in clinical and HRQoL outcomes, including a significantly higher proportion of patients achieving target albumin levels (>35g/dl; 79.8% compared to 74.2%, p<0.001) and a higher physical composite HROoL (74.4 compared to 70.3, p=0.02).Conclusion: This co-designed mHealth platform offered a scalable, patient-centred model that enhanced engagement and demonstrated clinical improvements.It enabled patients to be involved in their care and personalise their care experience.In particular it demonstrated improved quality of life with modest health benefits, previously not demonstrated in mHealth apps.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.