{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:54Z","timestamp":1782496554612,"version":"3.54.5"},"reference-count":56,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,26]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adults with chronic kidney disease (CKD) experience a wide range of symptoms that significantly lower their health-related quality of life (HRQoL). Using mobile-based applications for symptom assessment and management has the potential to alleviate the symptom burden of CKD and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a randomised feasibility trial to assess the feasibility, acceptability, usability and potential effects of a remote symptom assessment and management (SAM-CKD) 6\u2009week programme delivered via a mobile application. Adults aged 18 years or older with CKD grade 4 or 5 (including those on dialysis) will be randomly assigned to the SAM-CKD programme or usual care. Primary outcomes assess the intervention\u2019s feasibility, acceptability and usability. Secondary outcomes are changes in CKD symptoms and HRQoL between baseline, 3 weeks and 6 weeks later. Data analysis involves descriptive and intention-to-treat analyses. The study will be undertaken between December 2025 and March 2026. The findings will inform whether an effective trial is feasible and whether the study design and\/or its methods need modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was granted by the Vin University and Griffith University Human Research Ethics Committee. Results will be disseminated at the participating hospital and CKD patient groups and shared via peer-reviewed publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT07186361\">NCT07186361<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-111934","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T14:55:25Z","timestamp":1770389725000},"page":"e111934","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Remote symptom assessment and management via mobile app for adults with chronic kidney disease in Vietnam (SAM-CKD programme): a randomised feasibility trial protocol"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct07186361","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct07186361","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct07186361","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4436-9064","authenticated-orcid":false,"given":"Khanh Linh","family":"Bui","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areum","family":"Hyun","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Purtell","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"},{"name":"Kidney Health Service, Metro North Health, Brisbane, Queensland, Australia"},{"name":"Centre for Allied Health Research, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van L","family":"Hoang","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Phenikaa University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9920-6743","authenticated-orcid":false,"given":"Ann","family":"Bonner","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"},{"name":"Kidney Health Service, Metro North Health, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"2026062610412189000_16.2.e111934.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.07.012"},{"key":"2026062610412189000_16.2.e111934.2","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"The Lancet"},{"key":"2026062610412189000_16.2.e111934.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-007525","article-title":"Prevalence of chronic kidney disease in Asia: a systematic review and analysis","volume":"7","author":"Liyanage","year":"2022","journal-title":"BMJ Glob Health"},{"key":"2026062610412189000_16.2.e111934.4","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1177\/0193945920957229","article-title":"Correlates of Symptom Burden of Hemodialysis Patients","volume":"43","author":"Song","year":"2021","journal-title":"West J Nurs Res"},{"key":"2026062610412189000_16.2.e111934.5","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/NNR.0000000000000479","article-title":"A Mixed Methods Study of Symptom Experience in Patients With End-Stage Renal Disease","volume":"70","author":"Ng","year":"2021","journal-title":"Nurs Res"},{"key":"2026062610412189000_16.2.e111934.6","doi-asserted-by":"crossref","first-page":"5529","DOI":"10.3390\/jcm13185529","article-title":"Symptom Burden in Patients on Maintenance Hemodialysis: Prevalence and Severity 17 Years Apart","volume":"13","author":"Bossola","year":"2024","journal-title":"JCM"},{"key":"2026062610412189000_16.2.e111934.7","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/jorc.12303","article-title":"The Relationship Between Chronic Kidney Disease, Symptoms and Health-Related Quality of Life: A Systematic Review","volume":"46","author":"Yapa","year":"2020","journal-title":"J Ren Care"},{"key":"2026062610412189000_16.2.e111934.8","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12882-023-03176-4","article-title":"Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study","volume":"24","author":"Zhou","year":"2023","journal-title":"BMC Nephrol"},{"key":"2026062610412189000_16.2.e111934.9","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1111\/jan.13303","article-title":"Towards a symptom cluster model in chronic kidney disease: A structural equation approach","volume":"73","author":"Almutary","year":"2017","journal-title":"J Adv Nurs"},{"key":"2026062610412189000_16.2.e111934.10","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.2147\/PRBM.S465215","article-title":"The Mediating Effect of Symptom Burden in the Depression and Quality of Life in Patients with Maintenance Hemodialysis","volume":"17","author":"Xia","year":"2024","journal-title":"Psychol Res Behav Manag"},{"key":"2026062610412189000_16.2.e111934.11","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1053\/j.ajkd.2024.06.011","article-title":"Symptom Burden and Its Impact on Quality of Life in Patients With Moderate to Severe CKD: The International Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps)","volume":"84","author":"Speyer","year":"2024","journal-title":"Am J Kidney Dis"},{"key":"2026062610412189000_16.2.e111934.12","first-page":"618","article-title":"The Lived Experience of Patients with Chronic Kidney Disease: Insights From DISCOVER CKD","volume":"55","author":"Pollock","year":"2024","journal-title":"Am J Nephrol"},{"key":"2026062610412189000_16.2.e111934.13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/jorc.12478","article-title":"Impact of chronic kidney disease on everyday life: A descriptive qualitative study","volume":"50","author":"Yapa","year":"2024","journal-title":"J Ren Care"},{"key":"2026062610412189000_16.2.e111934.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-044059","article-title":"Patients\u2019 and healthcare professionals\u2019 beliefs, perceptions and needs towards chronic kidney disease self-management in China: a qualitative study","volume":"11","author":"Shen","year":"2021","journal-title":"BMJ Open"},{"key":"2026062610412189000_16.2.e111934.15","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2147\/IJNRD.S242235","article-title":"Current Management Strategies of Chronic Kidney Disease in Resource-Limited Countries","volume":"13","author":"Ameh","year":"2020","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"2026062610412189000_16.2.e111934.16","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.kint.2023.05.019","article-title":"Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"104","author":"Mehrotra","year":"2023","journal-title":"Kidney Int"},{"key":"2026062610412189000_16.2.e111934.17","doi-asserted-by":"crossref","first-page":"151546","DOI":"10.1016\/j.semnephrol.2024.151546","article-title":"Measuring Symptoms Across the Spectrum of Chronic Kidney Disease: Strategies for Incorporation Into Kidney Care","volume":"44","author":"Davison","year":"2024","journal-title":"Semin Nephrol"},{"key":"2026062610412189000_16.2.e111934.18","unstructured":"Humphreys J , Lee K , Carrieri-Kohlman V , et al . UCSF School of Nursing Symptom Management Faculty Group. Theory of Symptom Management Middle Range Theory for Nursing 2008;145\u201358."},{"key":"2026062610412189000_16.2.e111934.19","doi-asserted-by":"crossref","unstructured":"Flythe JE , Hilliard T , Lumby E , et al . Fostering Innovation in Symptom Management among Hemodialysis Patients: Paths Forward for Insomnia, Muscle Cramps, and Fatigue. Clin J Am Soc Nephrol 2019;14.","DOI":"10.2215\/CJN.07670618"},{"key":"2026062610412189000_16.2.e111934.20","first-page":"1951","article-title":"Living Well With Kidney Disease and Effective Symptom Management","volume":"7","author":"Rhee","year":"2022","journal-title":"Consensus Conference Proceedings Kidney International Reports"},{"key":"2026062610412189000_16.2.e111934.21","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-021-03003-z"},{"key":"2026062610412189000_16.2.e111934.22","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.ekir.2021.01.038","article-title":"A Narrative Review of Management Strategies for Common Symptoms in Advanced CKD","volume":"6","author":"Metzger","year":"2021","journal-title":"Kidney Int Rep"},{"key":"2026062610412189000_16.2.e111934.23","doi-asserted-by":"crossref","first-page":"151549","DOI":"10.1016\/j.apnr.2021.151549","article-title":"Symptom management in Chinese adults with end stage renal disease (ESRD)","volume":"64","author":"Levy","year":"2022","journal-title":"Appl Nurs Res"},{"key":"2026062610412189000_16.2.e111934.24","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.4103\/ijpc.ijpc_69_21","article-title":"Symptom Management among Patients with Chronic Kidney Disease","volume":"27","author":"Rao","year":"2021","journal-title":"Indian J Palliat Care"},{"key":"2026062610412189000_16.2.e111934.25","doi-asserted-by":"crossref","DOI":"10.2196\/12604","article-title":"Mobile Apps for the Care Management of Chronic Kidney and End-Stage Renal Diseases: Systematic Search in App Stores and Evaluation","volume":"7","author":"Siddique","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026062610412189000_16.2.e111934.26","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.25122\/jml-2023-0153","article-title":"The impact of mobile health applications on the outcomes of patients with chronic kidney disease: a systematic review and meta-analysis","volume":"16","author":"Ghozali","year":"2023","journal-title":"J Med Life"},{"key":"2026062610412189000_16.2.e111934.27","article-title":"eHealth interventions for people with chronic kidney disease","volume":"8","author":"Stevenson","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2026062610412189000_16.2.e111934.28","doi-asserted-by":"crossref","unstructured":"Shen H , Kleij R , Boog PJM , et al . Electronic Health Self-Management Interventions for Patients With Chronic Kidney Disease. Systematic Review of Quantitative and Qualitative Evidence J Med Internet Res 2019;21. doi:10.2196\/12384","DOI":"10.2196\/12384"},{"key":"2026062610412189000_16.2.e111934.29","doi-asserted-by":"crossref","first-page":"104991","DOI":"10.1016\/j.ijnurstu.2024.104991","article-title":"Conversational agents in physical and psychological symptom management: A systematic review of randomized controlled trials","volume":"163","author":"Yang","year":"2025","journal-title":"Int J Nurs Stud"},{"key":"2026062610412189000_16.2.e111934.30","doi-asserted-by":"crossref","first-page":"3560","DOI":"10.1111\/jocn.17827","article-title":"eHealth Solutions for Symptom Assessment and Monitoring in Adults With Chronic Kidney Disease: A Systematic Review","volume":"34","author":"Bui","year":"2025","journal-title":"J Clin Nurs"},{"key":"2026062610412189000_16.2.e111934.31","doi-asserted-by":"crossref","DOI":"10.2196\/29197","article-title":"A Mobile App to Support Self-management of Chronic Kidney Disease: Development Study","volume":"8","author":"Markossian","year":"2021","journal-title":"JMIR Hum Factors"},{"key":"2026062610412189000_16.2.e111934.32","doi-asserted-by":"crossref","DOI":"10.2196\/15549","article-title":"Intervention and Evaluation of Mobile Health Technologies in Management of Patients Undergoing Chronic Dialysis: Scoping Review","volume":"8","author":"Yang","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026062610412189000_16.2.e111934.33","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1053\/j.jrn.2021.06.006","article-title":"A Systematic Review and Qualitative Analysis of Existing Dietary Mobile Applications for People With Chronic Kidney Disease","volume":"32","author":"Russell","year":"2022","journal-title":"J Ren Nutr"},{"key":"2026062610412189000_16.2.e111934.34","doi-asserted-by":"crossref","DOI":"10.2196\/24638","article-title":"Acceptance and Use of Home-Based Electronic Symptom Self-Reporting Systems in Patients With Cancer: Systematic Review","volume":"23","author":"Cho","year":"2021","journal-title":"J Med Internet Res"},{"key":"2026062610412189000_16.2.e111934.35","doi-asserted-by":"publisher","DOI":"10.1177\/1460458220942649"},{"key":"2026062610412189000_16.2.e111934.36","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-082345","article-title":"Preferences of people with chronic kidney disease regarding digital health interventions that promote healthy lifestyle: qualitative systematic review with meta-ethnography","volume":"14","author":"Tr\u1ea7n","year":"2024","journal-title":"BMJ Open"},{"key":"2026062610412189000_16.2.e111934.37","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"Eldridge","year":"2016","journal-title":"BMJ"},{"key":"2026062610412189000_16.2.e111934.38","doi-asserted-by":"publisher","DOI":"10.1177\/0962280215588241"},{"key":"2026062610412189000_16.2.e111934.39","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s12882-021-02344-8","article-title":"Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial","volume":"22","author":"Dingwall","year":"2021","journal-title":"BMC Nephrol"},{"key":"2026062610412189000_16.2.e111934.40","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/tbm\/ibz077","article-title":"Technology-assisted cognitive-behavioral therapy intervention for end-stage renal disease","volume":"10","author":"Jakubowski","year":"2020","journal-title":"Transl Behav Med"},{"key":"2026062610412189000_16.2.e111934.41","unstructured":"Sealed Envelope Ltd . Create a blocked randomisation list. 2024. Available: https:\/\/www.sealedenvelope.com\/simple-randomiser"},{"key":"2026062610412189000_16.2.e111934.42","doi-asserted-by":"crossref","first-page":"54","DOI":"10.38148\/JHDS.0604SKPT22-046","article-title":"A mobile application to support self-management among people with chronic kidney disease in Vietnam: Study protocol for a codesign-based intervention","volume":"06","author":"Hoang Lan","year":"2022","journal-title":"JHDS"},{"key":"2026062610412189000_16.2.e111934.43","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2001.01697.x"},{"key":"2026062610412189000_16.2.e111934.44","doi-asserted-by":"crossref","DOI":"10.1590\/0034-7167-2020-1004","article-title":"Symptom management theory applied to nursing care: scoping review","volume":"74","author":"Silva","year":"2021","journal-title":"Rev Bras Enferm"},{"key":"2026062610412189000_16.2.e111934.45","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jpainsymman.2018.04.006","article-title":"Validation of the IPOS-Renal Symptom Survey in Advanced Kidney Disease: A Cross-sectional Study","volume":"56","author":"Raj","year":"2018","journal-title":"J Pain Symptom Manage"},{"key":"2026062610412189000_16.2.e111934.46","doi-asserted-by":"crossref","DOI":"10.2196\/36043","article-title":"A 3-Item Measure Of Digital Health Care Literacy: Development And Validation Study","volume":"6","author":"Nelson","year":"2022","journal-title":"JMIR Form Res"},{"key":"2026062610412189000_16.2.e111934.47","doi-asserted-by":"crossref","DOI":"10.2196\/11500","article-title":"The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study","volume":"7","author":"Zhou","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026062610412189000_16.2.e111934.48","doi-asserted-by":"crossref","unstructured":"Zhao S , Cao Y , Cao H , et al . Chinese Version of the mHealth App Usability Questionnaire: Cross-Cultural Adaptation and Validation. Front Psychol 2022;13. doi:10.3389\/fpsyg.2022.813309","DOI":"10.3389\/fpsyg.2022.813309"},{"key":"2026062610412189000_16.2.e111934.49","doi-asserted-by":"crossref","first-page":"100517","DOI":"10.1016\/j.smhl.2024.100517","article-title":"German mHealth App Usability Questionnaire (G-MAUQ) and short version (G-MAUQ-S): Translation and validation study","volume":"34","author":"Kopka","year":"2024","journal-title":"Smart Health (2014)"},{"key":"2026062610412189000_16.2.e111934.50","doi-asserted-by":"crossref","DOI":"10.2196\/24457","article-title":"Malay Version of the mHealth App Usability Questionnaire (M-MAUQ): Translation, Adaptation, and Validation Study","volume":"9","author":"Mustafa","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026062610412189000_16.2.e111934.51","doi-asserted-by":"crossref","unstructured":"Grochowicka M , Reysner M , Leppert W , et al . Integrated Palliative Care Outcomes Scale (IPOS): a review of the literature and studies on its use in patients with different conditions. Palliative Medicine in Practice 2024;0.","DOI":"10.5603\/pmp.100293"},{"key":"2026062610412189000_16.2.e111934.52","doi-asserted-by":"publisher","DOI":"10.1007\/S11136-020-02469-7"},{"key":"2026062610412189000_16.2.e111934.53","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2017.8.35985"},{"key":"2026062610412189000_16.2.e111934.54","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1093\/ndt\/gfad179","article-title":"Health-related quality of life and symptom burden in patients on haemodialysis","volume":"39","author":"van Oevelen","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2026062610412189000_16.2.e111934.55","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003954","article-title":"Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis","volume":"19","author":"Fletcher","year":"2022","journal-title":"PLoS Med"},{"key":"2026062610412189000_16.2.e111934.56","doi-asserted-by":"crossref","first-page":"227","DOI":"10.37526\/1526-744X.2022.49.3.227","article-title":"Exploring the Evidence: Symptom Burden in Chronic Kidney Disease","volume":"49","author":"Clark-Cutaia","year":"2022","journal-title":"Nephrol Nurs J"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-111934","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:43:46Z","timestamp":1782495826000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-111934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":56,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,6]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-111934"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-111934","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}