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Adoption of a novel smart mobile‐health application technology to track chronic immunosuppression adherence in solid organ transplantation: Results of a prospective, observational, multicentre, pilot study
Author(s) -
Melilli Edoardo,
Cestone Giuseppe,
Revuelta Ignacio,
Meneghini Maria,
Lladó Laura,
Montero Nuria,
Malles Anna,
Diaz Maribel,
Coloma Ana,
Torregrosa Vicenç,
Baliellas Carme,
Cruzado Josep M.,
Diekmann Fritz,
Grinyó Josep,
Bestard Oriol
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14278
Subject(s) - medicine , immunosuppression , observational study , transplantation , kidney transplantation , prospective cohort study
Background Low adherence to chronic immunosuppression is associated with suboptimal transplantation outcomes. Mobile‐health technology is a promising tool to monitor medication adherence, but data on patient engagement to these tools are lacking. Methods Prospective, observational, multicenter, 2‐phase trial in kidney and liver transplant recipients, investigating the degree of engagement to TrackYourMed ® (TYM), a novel m‐Health technology with a QR code‐scan app to track immunosuppression adherence and its association with drug monitoring. Results Out of 204 consecutive transplant patients, 90 patients were eligible to participate. 61 (68%) used TYM regularly, 21 (23%) never or barely used it, 5 (5.5%) were irregular users, and 3 (3.3%) were lost to follow‐up. 6‐month total correct intakes (CIN) ranged between 69%–76%, 12%–19% intakes were out‐of‐time (OUT), and 9%–12% were missed (MIS). Notably, a rate of intakes out of the scheduled time higher than 20% in the 6 days prior to blood immunosuppressant trough levels was associated with a higher intra‐patient variability (17 IQR 13–21% vs. 29 IQR 23%–36%, p = .001), and with a higher dose‐adjustment ( p < .001). At 1 year, 53(59%) patients were still active users of TYM. Conclusions Implementing m‐Health technologies promoting immunosuppression adherence may be useful for a relevant number of transplant patients and help transplant physicians identifying erratic immunosuppression adherence.