A scoping review of existing literature on mobile health (mHealth) finds possible benefits for self-management among patients undergoing dialysis, but a significant room for advancement remains.
“Although mHealth holds potential advantages for self-management in patients undergoing dialysis, it has not been widely adopted and integrated into standard renal care, requiring further optimization and refinement,” the researchers said.
A total of 1,483 relevant studies were identified, of which 34 (n=2,068 patients) met the eligibility criteria. Self-management among patients undergoing dialysis involved the following major areas: self-monitoring, diet and fluid management, medication management, disease-related knowledge, exercise management, and psychological management. [J Med Internet Res 2026;28:e76880]
Most studies used a single application (n=22) for managing patients on dialysis, while other used online interventions (n=6) and a remote patient monitoring system (n=3). The mHealth-based interventions in this review centred on self-monitoring, dietary and fluid management, and medication management.
Theories most applied in the studies were the transtheoretical model and stages of change (n=5), self-efficacy theory (n=4), and social cognitive theory (n=4).
For objective indicators, the most common were interdialytic weight gain (n=12), serum potassium (n=14), serum phosphorus (n=20), and serum albumin (n=14). Subjective indicators were evaluated via scales covering adherence (n=17), self-efficacy (n=14), quality of life (n=12), knowledge (n=9), and diet and nutrition (n=9).
Enhanced outcomes
Several studies showed significant improvements in self-management of patients undergoing dialysis and better patient outcomes with mHealth-based interventions. [Jpn J Nurs Sci 2019;16:396-406; Jpn J Nurs Sci 2024;21:e12555; BMC Geriatr 2024;24:378; Med Surg Nurs J 2022;11:1-8; J Ren Nutr 2021;31:403-410; J Ren Nutr 2011;21:492-498]
Interventions using mHealth demonstrated greater impact on patient adherence and laboratory outcomes compared with face-to-face training. Applications and remote monitoring systems were commonly used tools. SMS text messaging and phone calls also aided at promoting self-management among dialysis patients. [BMC Nephrol 2023;24:194; Int J Med Inform 2022;165:104811]
“Due to differences in mHealth-based intervention content and evaluation indicators, quantitative analysis of apps, remote monitoring systems, phones, and SMS text messaging is extremely challenging,” the researchers said.
Overall, most applications demonstrated potential for improving medication adherence, care efficiency, and patient satisfaction and treatment outcomes. [J Med Internet Res 2025;27:e53144; Healthcare (Basel) 2024;12:593]
“Our findings not only provide a theoretical framework for optimizing clinical management strategies for patients undergoing dialysis but also offer targeted guidance and practical insights for the subsequent development of apps,” the researchers said.
This scoping review was guided by Arksey and O’Malley’s methodology, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews, and PRISMA Literature Search Extension. A systematic search was conducted using the databases of PubMed, Embase, Cinahl, PsycINFO, and Web of Science from January 2010 through October 2025.
The researchers used the Mixed Methods Appraisal Tool to assess the quality of included studies. They also extracted, mapped, and summarized quantitative studies and used a structured spreadsheet to collate and synthesize the results.
“Future research in this field should focus on enhancing adaptive software development, deeply integrating artificial intelligence technologies, addressing the needs of special populations, and establishing a standardized self-management evaluation system,” the researchers said.
“mHealth is a medical and public health service initiative based on mobile communications technology delivered through mobile phones, monitoring devices, personal digital assistant devices, and other wireless devices,” they said. [JMIR Mhealth Uhealth 2020;8:e15549]