Technology Triggered Adherence Intervention – Preliminary Findings
T. E. Kaiser1, N. S. Ejaz1, S. Tremblay1, N. J. Parrish2, J. Benavides2, B. Rehe2, A. Govil1, E. S. Woodle1, R. R. Alloway1
1University of Cincinnati, Cincinnati, OH, 2UC Health, Cincinnati, OH
Meeting: 2019 American Transplant Congress
Abstract number: 185
Keywords: Adverse effects, Immunosuppression, Kidney, Outpatients
Session Information
Session Name: Concurrent Session: Psychosocial and Treatment Adherence
Session Type: Concurrent Session
Date: Sunday, June 2, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 5:30pm-5:42pm
Location: Room 208
*Purpose: Medication non-adherence (M-NA) after renal transplant (RT) increases the risk of graft failure. We conducted a prospective, randomized, single center trial to evaluate 3 strategies combining traditional and novel adherence measures and interventions on M-NA post-RT.
*Methods: 3-9 months post-RT, patients on stable tacrolimus (TAC) doses and able to self-administer medications were randomized (1:1:1) to standard pillbox (G1), electronic pillbox (G2) or electronic pillbox + adherence intervention (G3) over 6 months. Preliminary analyses includes: 1) Self report (Basel Assessment of Adherence Scale for Immunosuppressive [BAASIS©] questionnaire); 2) TAC concentration variability (TAC CV% = standard deviation/mean) calculated with the 5 prior TAC levels; 3) Electronic pillbox % ON-TIME events (# ON TIME/# total events) for G2-3. Means calculated per time point per group and compared. Funding: AST TIRN grant.
*Results: 45 RT (G1 [16], G2 [14], G3 [14]) recipients enrolled 5/16-11/17. Exclusions: G2 (1subject, TAC stopped), G3 (1 subject analyzed as G1 since no pillbox connectivity). Participants were male (61%), Caucasian (57%), living donor (52%), aged 57 (range 23-76) at RT. Enrollment occurred at 91 (range 75-130) days post RT. Per BAASIS© 17.8% (53/297) were non-adherent. Self-report remained between 95-99%, appeared to decrease with time for G2. TAC CV% remained < 30% during the study and was similar amongst groups. ON-TIME % of events did not differ amongst G2-3. Figures 1-3 summarize adherence measures per group.
*Conclusions: Active adherence monitoring and coaching is feasible and accepted by RT recipients. We found similar findings amongst groups, but a full analysis including electronic pillbox data and pharmacy records is underway to more completely assess the impact of various monitoring strategies + interventions on M-NA post RT. Identifying RT subgroups that may benefit from adherence interventions may minimize negative outcomes post-RT. Active M-NA interventions may have added benefit over passive alerts/reminders.
To cite this abstract in AMA style:
Kaiser TE, Ejaz NS, Tremblay S, Parrish NJ, Benavides J, Rehe B, Govil A, Woodle ES, Alloway RR. Technology Triggered Adherence Intervention – Preliminary Findings [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/technology-triggered-adherence-intervention-preliminary-findings/. Accessed November 22, 2024.« Back to 2019 American Transplant Congress