Baseline Findings from the UREAACT Trial to Improve Medication Adherence in Youth with Kidney Transplants
1CHOP, Phila, PA, 2UPenn, Phila, PA, 3CHOA, Atlanta, GA, 4Boston Children's, Boston, MA, 5Children's Mercy, Kansas City, MO, 6Seattle Children's, Seattle, WA, 7Cleveland Clinic, Cleveland, OH, 8Lurie Children's, Chicago, IL, 9LaSalle Univ, Phila, PA
Meeting: 2022 American Transplant Congress
Abstract number: 816
Keywords: Kidney transplantation, Pediatric, Psychosocial
Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: This abstract describes the design and baseline characteristics of participants in the U-REAACT trial, a study to improve medication adherence in youth with kidney transplants using text reminders integrated with positive, tailored messaging based on adherence behavior (to support intrinsic motivation) and financial incentives (to spark extrinsic motivation).
*Methods: This is a multi-site, randomized clinical trial of youth with kidney transplants, ages 12-24. Using a web-based platform, participants receive either 1) daily text reminders or 2) daily text reminders with a weekly financial incentive of $10 USD if ≥85% of prescribed medications are taken on time and weekly motivational messages based on adherence performance. The study duration is one year with financial incentives tapered every two months in the latter half. The primary outcome is the difference in the proportion of weeks meeting adherence goals between arms. We also measure perceived adherence barriers, using the Adolescent Medication Barriers Scale (AMBS) and Parent Medication Barriers Scale (PMBS).
*Results: We enrolled 157 participants from July 2017 – April 2021, with 79 randomized to arm A and 78 to arm B. Enrollment has closed. Ten participants remain active in the study and arm assignments remain blinded. Baseline patient demographic characteristics are shown in Table 1. On the baseline AMBS, over 40% of participants reported feeling “tired of living with a medical condition” and over 33% were “tired of taking medication”. On the PMBS, 40% of parents reported: “my child relies on me to remind them to take their medicine” and 40% reported: “I am not always there to remind them.”
*Conclusions: This is the first randomized clinical trial to rigorously test the effectiveness of tailored text messaging with financial incentives to improve adherence in youth with kidney transplants. At baseline, participants endorsed adherence barriers related to disease frustration, suggesting that text reminders alone may be insufficient to promote positive adherence behavior. The study concludes in April 2022, with unblinded results available by June. Results will help advance understanding of the efficacy of incentives with tailored feedback to support medication adherence in youth.
To cite this abstract in AMA style:
Amaral S, Kwong P, Zhu J, George R, Rodig N, Warady B, Smith J, Bobrowski A, Matossian D, Zelikovsky N, Schwartz L, Reese P, Terry RGoldfarb, Reason J, Chung A, Furth S. Baseline Findings from the UREAACT Trial to Improve Medication Adherence in Youth with Kidney Transplants [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/baseline-findings-from-the-ureaact-trial-to-improve-medication-adherence-in-youth-with-kidney-transplants/. Accessed May 17, 2025.« Back to 2022 American Transplant Congress