Introduction. Transplant outcomes can be negatively influenced by medication nonadherence. Therefore, there is a need for effective interventions to improve adherence. In recent years due to developments in technology, e-health interventions have gained popularity. However, an e-health intervention for kidney patients will be effective only if patients are willing to adopt the intervention and have the facilities to do so. In this study we explored patients' internet-use, smartphone-use and their willingness to participate in online or offline self-management support interventions (SMSI's). Secondly, we explored if adherence was associated with internet-use and the willingness to participate in a SMSI, and if the willingness to participate in an online SMSI differed with age.

Methods. Patients who received a kidney transplant between 2010 and 2011 were invited to participate in a prospective cohort study. The questionnaires used for this study were administered 18 months post-transplant. Questions for exploring e-health potential were specifically designed. Adherence was measured using the Basel Assessment of Adherence to Immunosuppressive Medication Scale©.

Results. Almost 60% of the patients owned a smartphone, but only 4% used apps for health-purposes. However, 50% of all patients used internet to find information about their disease. Nonadherent patients were significantly more likely to use internet to look up health information (p<0.05). 70% was not willing to participate in the SMSI's, neither online nor offline. Only 17% would participate in an offline SMSI and 26% would participate in an online SMSI (of which 13% would participate in both). No difference was found in willingness to participate in an offline or online SMSI between adherent or nonadherent patients, (p=0.53, p=0.55, respectively). Patients who would participate in an online SMSI were significantly younger, than patients who would not (p<0.05).

Discussion. The majority of kidney transplant recipients owned a smartphone, and internet is well-used to find health-related information. However, patients are not very willing to participate in SMSI's. For successful intervention-implementation, developers must take this into account.

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