Digital self-management application for patients undergoing hemodialysis: influences on health awareness and frailty

Abstract Background Digital health interventions are increasingly used to support self-management in chronic kidney disease; however, their effects on patient-centered outcomes in maintenance hemodialysis (HD) patients remain unclear. This pilot feasibility study investigated the potential impact of a digital self-management application on health awareness, frailty, and eHealth literacy. Methods This single-group before-and-after observational study included 12 patients undergoing HD. Participants used a researcher-developed digital self-management application (“eCare”) for 3 months. Clinical parameters, Health Consciousness Scale (HCS) scores, eHealth literacy, and frailty assessed using the Kihon Checklist were evaluated before and after the intervention. Participants were also categorized as active or passive users according to application engagement. Results Hemoglobin levels significantly increased after the intervention, whereas other biochemical and dialysis-related parameters remained stable. Total HCS scores significantly changed, with notable improvements in prevention-related awareness and dependence on treatment. Frailty scores showed a trend toward improvement, particularly depressive symptoms. eHealth literacy scores remained stable throughout the study period. Active users demonstrated greater improvements in prevention-related awareness and cognitive function than passive users. Conclusions This pilot feasibility study suggests that digital self-management applications may influence health awareness and selected patient-centered outcomes in HD patients, particularly psychological aspects of frailty. Larger controlled multicenter studies are needed to further evaluate the long-term clinical and psychosocial effects of digital health interventions in dialysis care.