Clinician-informed design requirements for CKD-specific digital therapeutics: A focus group study with nephrologists to guide clinically integrated intervention development

초록

Background Chronic kidney disease (CKD) requires complex self-management across medication use, dietary restriction, symptom monitoring, and ongoing clinical follow-up. However, many existing digital health tools remain disease-agnostic and may not adequately address the clinical specificity and safety needs of CKD care.Objective To identify clinician-informed design requirements for CKD-specific digital therapeutics by eliciting nephrologists' perspectives on unmet clinical needs, safety-related functions, and workflow integration requirements.Methods Online focus group interviews were conducted with 19 nephrologists purposively sampled from secondary and tertiary hospitals in South Korea. Verbatim transcripts were independently coded by four researchers and analyzed using inductive thematic analysis, with discrepancies resolved through consensus discussions.Results Four interrelated design domains emerged. First, clinical adoption and usability included age-sensitive interfaces, caregiver-mediated access, and low-burden data entry. Second, medication safety and adherence infrastructure included nephrotoxicity alerts, medication identification support, and integration for polypharmacy management. Third, longitudinal disease and complication monitoring emphasized interpretable visualization of laboratory trends and incorporation of patient-generated data into outpatient care. Fourth, lifestyle intervention support highlighted CKD-specific dietary guidance, AI-assisted meal analysis, and wearable-informed physical activity feedback.Conclusions This study identified clinician-informed design requirements for CKD-specific digital therapeutics through focus group interviews with nephrologists. The findings indicate that nephrologists prioritize safety-related functions, disease-specific content, and workflow-integrated design as key requirements that current disease-agnostic digital health tools do not adequately address. Future studies should incorporate patient perspectives and prospective prototype evaluation to validate these requirements.

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