Purpose: The Teen Adherence in KidnEy Transplant – Improving Tracking to Optimize Outcomes (TAKE-IT TOO) study was designed to adapt the efficacious Take-IT intervention for use in real world practice. TAKE-IT TOO aimed to understand the perspectives of recipients, parents, and healthcare professionals (HCPs) regarding how to apply an adherence-promoting intervention in practice.

Methods: Separate focus groups were held for recipients (aged 12-24), parents and healthcare professionals (HCPs) from 3 kidney transplant centers in the U.S. and 4 in Canada. Perspectives about medication adherence and intervention elements, including an electronic monitoring pillbox (e-pillbox), coaching and action planning, were explored. Qualitative techniques were used to identify groups' perspectives.

Results: A total of 32 recipients, 15 parents, and 46 HCPs participated. Recipients reported challenges adhering to medications. HCPs expressed frustration with the lack of reliable measures of adherence, mistrust of patient-reported adherence, and limited resources to support adherence. Parents expressed need for easy communication with their child to confirm adherence. All stakeholder groups were concerned that coaching may extend the length of visits and adding a coach who was not part of the team may have drawbacks. All parties viewed the e-pillbox positively and recommended text alerts, portability and removable medication compartments. Parents and HCPs considered the web-site as a way to track adherence data, but not without potential risks (e.g., liability, knowing when to intervene, and data overload). Parents and HCPs felt that adolescents needed more education and support for medication adherence and identified deficits in their own knowledge about monitoring adherence, whereas adolescents wanted further education about transplant and transitioning to adult care. Links between adherence and transition to independence were identified by all stakeholder groups.

Conclusions: In spite of some commonalities, the priorities and challenges for adolescents, parents and HCPs regarding medication adherence varied. Findings from the focus groups will inform adaptation of the TAKE-IT adherence-promoting intervention for integration into clinical practice. Funded by R01 DK110737.

CITATION INFORMATION: Nguyen C., Dew M., DeVito Dabbs A., Irizarry T., McNulty M., Foster B. Promoting Medication Adherence from the Perspectives of Teen and Young Adult Kidney Recipients, Parents and Health Care Professionals Am J Transplant. 2017;17 (suppl 3).

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