Should We Recommend Renal Diet Apps for our Patients? A Content Analysis of Health Apps for Kidney Patients

High smartphone penetration in Malaysia makes the mobile health (mHealth) apps a suitable approach to enhance the self-management skills of local dialysis patients in view of the high rate of dietary and fluid non-adherence. Remarkable features of mHealth apps such as real-time feedback and freely accessible, allow kidney patients to monitor and manage their dietary intake at arm’s reach and low cost. Nevertheless, their utility in the Malaysian context remains questionable. Therefore, we conducted a content analysis of existing renal diet apps in Google Play and Apple App stores searched using plausible terms that patients would use in Malay and English. Apps were excluded if they were not relevant to kidney patient’s care, not meant for patient’s self-management or redundant. Apps were evaluated for option of multi-language (sub-score=1), credibility (sub-score=1), food database (sub-score=1), valuable features (sub-score=12), health behavior theoretical (HBT) constructs (sub-score=60) and technical quality (sub-score=25).

Stepwise multiple linear regression analysis was performed to identify features that predict the technical quality of apps. A total of 22 out of 253 apps were eligible for evaluation. On the basis of the 100-point scale, the mean overall score of apps was 31.13±14.08. No apps contained Malay language and Malaysian food database. About 54.5% of the apps were not credible. The apps scored 13.41±11.56 (out of 60) for HBT constructs. The overall app technical quality was considered poor with the mean score of 2.69±0.41 (out of 5). HBT constructs such as self-monitoring could significantly predict both subjective quality (b=0.518, P=.008) and engagement quality (b=0.853, P=.001) of the apps. In conclusion, although most of the existing renal diet apps were available for free and easy to use, they were subjected to theory deficient, limited language option and lacking in food databases, credibility, tailored education, and overall technical quality. Thus, they might have limited utility for Malaysian dialysis patients.