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Online Nutrition Algorithm For Hemodialysis Patients Improves Dietitian-Patient Interactions

2012; Elsevier BV; Volume: 31; Issue: 2 Linguagem: Inglês

10.1016/j.krcp.2012.04.397

2211-9140

Rosa K. Hand, Janeen B. León, Lílian Cuppari, Alison Steiber,

Mobile Health and mHealth Applications

The purpose of this study was to determine the usability of an online nutrition algorithm for hemodialysis patients by surveying a group of dietitians testing the algorithm. Subjects were invited to take 2 different online surveys, one at month 3 (n=22) and one at month 6 (n=14). JMP version 9.0.2 was used for analysis and significance was set at p<0.05. There was a 73% response rate for survey 1 with a mean of 8.5±4.5 patient visits using the algorithm (range 0-16). Forty-five percent of respondents were from the US, and 55% worked in a chain-based outpatient dialysis facility. Seventy-two percent reported that it was harder than expected to use the algorithm, with half mentioning the time to enter data as a main difficulty. One dietitian used a computer directly at chair-side; 41% thought that using a computer at chair-side would make the process easier or much easier, while 36% thought it would be harder or much harder. Fifty percent thought using the algorithm improved their patient interactions while 41% saw no change. Thirty-six percent felt the algorithm was logical and/or easy and 36% were neutral. Dietitians more experienced with the algorithm were more likely to rate it as logical (ns). There was a 100% response rate in the second survey. Respondents worked at chain-based outpatient facilities in the USA, and all had used the algorithm for 6 months on 2–4 patients. Sixty-four percent of respondents felt the algorithm improved or significantly improved their patient interactions, the remainder saw no change, and 57% thought the algorithm increased their understanding of the patient's condition. Algorithm use increased the mean estimated monthly nutrition care time per patient compared to average habits (p<0.001); 45±27 minutes without the algorithm,100±43 minutes in month 1 of the algorithm, and 77±35 minutes in the last month. The additional time was distributed evenly between interaction and documentation. These surveys show that dietitians felt that an online nutrition algorithm may improve dietitian-patient interactions and understanding of patient conditions which may be helpful in medically complex cases.