Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 19;2(2):e14.
doi: 10.2196/formative.9707.

Web-Based Tailored Intervention to Support Optimal Medication Adherence Among Kidney Transplant Recipients: Pilot Parallel-Group Randomized Controlled Trial

José Côté  1   2   3 , Marie-Chantal Fortin  3   4 , Patricia Auger  1   3 , Geneviève Rouleau  1   3 , Sylvie Dubois  2 , Nathalie Boudreau  4 , Isabelle Vaillant  4 , Élisabeth Gélinas-Lemay  4
Affiliations

Web-Based Tailored Intervention to Support Optimal Medication Adherence Among Kidney Transplant Recipients: Pilot Parallel-Group Randomized Controlled Trial

José Côté et al. JMIR Form Res. .

Abstract

Background: Optimal immunosuppressive medication adherence is essential to graft survival. Transplant-TAVIE is a Web-based tailored intervention developed to promote this adherence.

Objective: The objective of our study was to evaluate the Transplant-TAVIE intervention's acceptability, feasibility, and preliminary efficacy.

Methods: In a pilot, parallel-group, randomized controlled trial, we randomly assigned a convenience sample of 70 kidney transplant patients on immunosuppressive medication either to an experimental group (Transplant-TAVIE) or to a control group (existing websites). Kidney transplant recipients had to be older than 18 years, be taking immunosuppressant medication, and have access to the internet to participate in this study. Transplant-TAVIE was composed of three interactive Web-based sessions hosted by a virtual nurse. We documented user appreciation of and exposure to the intervention. Furthermore, we assessed medication adherence, medication self-efficacy, intake-related skills, and medication side effects at baseline and 3 and 6 months later. Analyses of variance were used to assess intergroup differences over time.

Results: After baseline questionnaire completion, participants were randomly assigned either to Transplant-TAVIE (n=35) or to the websites (n=35) group. All participants had received their kidney graft <1 year to 32 years earlier (mean 6.8 years). Of the experimental group, 54% (19/35) completed the sessions of Transplant-TAVIE. Users found the intervention to be acceptable-33% were extremely satisfied (6/18), 39% were very satisfied (7/18), and 28% were satisfied (5/18). At baseline and over time, both experimental and control groups reported high medication adherence, high medication self-efficacy, and frequent use of skills related to medication intake. No intergroup differences emerged over time.

Conclusions: The results of this study support the feasibility and acceptability of Transplant-TAVIE. It could constitute an accessible adjunct in support of existing specialized services.

Keywords: Web-based tailored intervention; medication adherence; nursing; randomized controlled trial; self-management; transplant recipient.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Granting of licensing options for marketing VIH-TAVIE.

Figures

Figure 1
Figure 1
Screenshot of Transplant-TAVIE intervention.
Figure 2
Figure 2
Participant flow diagram. ANOVA: analysis of variance.
See this image and copyright information in PMC

References

    1. Denhaerynck K, Schmid-Mohler G, Kiss A, Steiger J, Wüthrich RP, Bock A, De Geest S. Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients. Int J Organ Transplant Med. 2014;5(1):7–14. http://europepmc.org/abstract/MED/25013673 - PMC - PubMed
    1. Takemoto S, Port FK, Claas FH, Duquesnoy RJ. HLA matching for kidney transplantation. Hum Immunol. 2004 Dec;65(12):1489–1505. doi: 10.1016/j.humimm.2004.06.008.S0198-8859(04)00147-8 - DOI - PubMed
    1. Dew MA, DiMartini AF, De Vito DA, Myaskovsky L, Steel J, Unruh M, Switzer GE, Zomak R, Kormos RL, Greenhouse JB. Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation. 2007 Apr 15;83(7):858–873. doi: 10.1097/01.tp.0000258599.65257.a6.00007890-200704150-00005 - DOI - PubMed
    1. De Bleser L, Matteson M, Dobbels F, Russell C, De Geest S. Interventions to improve medication-adherence after transplantation: a systematic review. Transpl Int. 2009 Aug;22(8):780–797. doi: 10.1111/j.1432-2277.2009.00881.x. doi: 10.1111/j.1432-2277.2009.00881.x.TRI881 - DOI - DOI - PubMed
    1. Low JK, Williams A, Manias E, Crawford K. Interventions to improve medication adherence in adult kidney transplant recipients: a systematic review. Nephrol Dial Transplant. 2015 May;30(5):752–761. doi: 10.1093/ndt/gfu204.gfu204 - DOI - PubMed

LinkOut - more resources