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Pilot RCT tests digital inclusion intervention for adults with chronic kidney diseaseFree Tablets and Training Bridge the Digital Health Gap

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Key Takeaway
Consider this pilot RCT shows feasibility of a digital inclusion intervention for CKD, but efficacy is unproven.

This pilot mixed-methods randomized controlled trial enrolled 40 digitally excluded adults with chronic kidney disease (CKD) at a single site. Participants had a median age of 66.5 years and a median Digital Health Care Literacy Scale score of 4. The intervention group received a Wi-Fi-enabled iPad with the Kidney Beam program, digital literacy training, and ongoing support, while the control group received only sign-up instructions for Kidney Beam.

The primary outcome was feasibility, assessed against prespecified criteria. Of 169 individuals screened, 40 were enrolled. At 12 weeks, 35 of 40 participants (88%) completed follow-up (intervention: 18/21; control: 17/19). All prespecified feasibility criteria for screening, recruitment, retention, adherence, and safety were met. Qualitative interviews with 25 participants indicated the tablet loan and training were acceptable and highly valued.

Quantitative results for secondary outcomes (Kidney Disease Quality of Life, Chalder Fatigue, Patient Health Questionnaire-4) were not reported. Safety criteria were met, with no specific adverse events reported; 5 of 40 participants (12.5%) did not complete follow-up.

Key limitations include the pilot single-site design, small sample size, short 12-week follow-up, and lack of reported quantitative secondary outcome data. The findings support progression to a definitive multicenter trial but do not establish efficacy for clinical outcomes.

  • Loaned iPads and training help patients use health apps
  • Older adults with kidney disease and no tech access
  • Still early research; not ready for clinics yet

Giving devices and training makes digital health work for people who usually get left behind.

Imagine trying to book a doctor's visit online. You do not have a computer. You feel stuck and frustrated.

Health care is moving online fast. The National Health Service wants more digital tools. But many people cannot use them. This leaves them behind.

Chronic kidney disease affects millions of people. They need regular check-ups and advice. If they cannot use the app, they miss out. This creates unfair gaps in care.

Feeling left behind in modern care

Doctors used to send links and hope for the best. They assumed everyone had a smartphone. But that is not true for everyone.

Some people do not own a device. Others do not know how to use one. They need more than just a link. They need the tool itself.

Why digital tools leave people out

Think of it like learning to drive. You cannot just read a manual. You need a car and a teacher. This study gave people both.

Researchers gave tablets to people who needed them. They also taught them how to use the screen. This built confidence and trust.

The surprising shift in approach

The team tested this with 40 adults. They all had kidney disease. They did not have good internet access.

The group used a special health app for 12 weeks. One group got the tablet and help. The other group got instructions only.

How giving a tablet changes things

Most people finished the program. Eighty-eight percent stayed until the end. This is a very high number.

Users said the training made them feel stronger. They liked having a device they could keep using. It solved the biggest barrier.

Real results from real patients

This doesn’t mean this treatment is available yet.

Experts say this is a fair way to start. It helps close the gap between rich and poor. Technology should help everyone, not just some.

You cannot get this tablet today. It is still in the testing phase. But it shows a better path forward.

Talk to your doctor about digital options. Ask if they have support for tech issues. Do not give up if it is hard.

What this means for your care

The study was small and short. It only happened at one location. We need more data to be sure.

More trials will test this idea widely. Doctors hope to offer this support soon. The goal is care for all.

The NHS plans to use more digital tools. This plan needs to include everyone. We must find ways to help those who struggle.

Many older adults feel overwhelmed by technology. They do not want to be left out. They want to manage their health safely.

This study shows a clear solution. It is not just about the app. It is about the support around it.

People with low digital skills often feel shame. They do not want to ask for help. Giving them a device removes that shame.

The training helped them feel capable again. They learned how to log in safely. They learned how to join live sessions.

This approach works for other long-term conditions too. It is not just for kidney disease. It could help anyone with a chronic illness.

The study was a pilot trial. It was designed to test the idea. It was not a final approval test.

We need to see if this works everywhere. One hospital is not the whole country. Different areas have different needs.

The cost of tablets is also a factor. Can the health system afford this? It is a big investment.

But the cost of poor health is higher. People who miss care get sicker. They need more help later.

This is a small step forward. It is not the whole journey. But it is a good direction.

More trials will test this idea widely. Doctors hope to offer this support soon. The goal is care for all.

Study Details

Study typeRct
Sample sizen = 25
EvidenceLevel 2
Follow-up120.0 mo
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: The National Health Service 10-year health plan emphasizes an increasing shift toward digital health care delivery. However, there is limited research on how best to support, engage, and include individuals who are digitally excluded. As health care services become more digitally driven, evidence-based interventions are needed to address digital exclusion and ensure equitable access to care, particularly for people living with long-term conditions. OBJECTIVE: This study aimed to evaluate the feasibility and acceptability of providing digital literacy training alongside a digital health intervention (DHI; Ex-Tab intervention), compared with providing a DHI alone. Kidney Beam, a DHI designed to promote physical activity and improve quality of life in people with chronic kidney disease (CKD), was used as an exemplar DHI. METHODS: This mixed methods, single-site pilot randomized controlled trial recruited 40 adults with CKD who were digitally excluded. Digital exclusion was defined as lacking access to a Wi-Fi-enabled digital device or having a Digital Health Care Literacy Scale (DHLS) score of <7 (range 0-21). Participants were randomized 1:1 to receive either the Kidney Beam Ex-Tab intervention or Kidney Beam alone (control). The intervention group received a Wi-Fi-enabled iPad on loan with Kidney Beam preinstalled, digital literacy training, and ongoing support to access the 12-week Kidney Beam program (twice weekly live exercise and education sessions). The control group received sign-up instructions for Kidney Beam only. Feasibility outcomes were assessed against a priori progression criteria and included screening, recruitment, retention, adherence, safety, and acceptability. Secondary outcomes included the Kidney Disease Quality of Life Questionnaire, Chalder Fatigue Questionnaire, and Patient Health Questionnaire-4. Outcomes were measured at baseline and 12 weeks. Acceptability and user experience were explored through semistructured interviews with participants from both groups at 12 weeks (n=25). RESULTS: Between September 2023 and September 2024, a total of 169 individuals were screened and 40 were enrolled (median age 66.5 years; 20 male individuals; median DHLS score: 4). Twenty-one participants were randomized to the Kidney Beam Ex-Tab group and 19 to the Kidney Beam alone group. Of the 40 participants, 35 (88%) completed the 12-week follow-up (intervention: n=18; control: n=17). All prespecified feasibility criteria for recruitment, retention, adherence, and safety were met. Qualitative findings indicated that the tablet loan and digital literacy training were acceptable and highly valued, enhancing confidence, motivation, and DHI engagement. Providing loaned devices was particularly important for overcoming access barriers, especially for participants unable to afford their own device. CONCLUSIONS: Providing Wi-Fi-enabled devices and digital literacy training alongside a DHI was feasible and acceptable for people with lower digital literacy levels. The findings support progression to a future definitive multicenter trial or implementation study and offer transferable insights for the design of digital inclusion strategies for other long-term health conditions.
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