Perspectives of people with chronic kidney disease regarding digital health interventions that promote a healthy lifestyle: qualitative systematic review

Chronic kidney disease (CKD) is a life-limiting condition that affects 1 in 10 adults and accounts for 12% of all deaths in Australia. Diet and physical activity are crucial to attenuate disease progression and reduce mortality risk. Digital health interventions have been proposed as a feasible model to deliver lifestyle interventions. Users’ perspectives are key to ensure the intervention is aligned with their needs and goals. As such, this systematic review aimed to synthesise the perspectives of people with CKD and develop higher order concepts that elucidate users’ preferences regarding digital health interventions that promote heathy lifestyle. This was a qualitative systematic review. A database search was conducted on CENTRAL, Scopus, MEDLINE, CINAHL and SPORTDiscus between 2000-2023. Eligibility criteria included primary research that reported the preferences of adults with CKD regarding digital lifestyle interventions. Two independent reviewers completed title, abstract and full text screening. Quotes were extracted verbatim, coded and categorised. Categories were then used to generate themes. Database search identified 5,761 records. One additional record was included following communication with a primary author. Fifteen papers were eligible, including 197 participants (age 51.0±7.2 years; 47% female). There were 83 people with CKD 1-5; 61 transplant recipients; and 53 people receiving maintenance dialysis. The overarching theme identified was that people with CKD considered digital interventions to be important platforms to access lifestyle interventions. There were five underlying themes that elucidated users’ preferences for digital interventions, including simple instruction and engaging design; individualised interventions; virtual communities of care; education and action plans; and timely reminders and automated behavioural monitoring. Digital health interventions were considered important platforms to deliver lifestyle interventions. Future research may apply users’ preferences in this review to inform the development and conduct of a digital lifestyle intervention for people with CKD.