A Prospective Randomized Trial on the Effect of Using an Electronic Monitoring Drug Dispensing Device to Improve Adherence and Compliance
| Autor: | Jonas Wadström, Gunnar Tydén, Jarmo Henriksson, Jonas Höijer |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Adolescent Biopsy Electrical Equipment and Supplies 030232 urology & nephrology MEDLINE 030230 surgery Medication Adherence law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Randomized controlled trial Risk Factors law Medical advice Intervention (counseling) medicine Humans Prospective Studies Child Prospective cohort study Intensive care medicine Aged Sweden Internet Transplantation business.industry Graft Survival Equipment Design Middle Aged Kidney Transplantation Compliance (physiology) Treatment Outcome Creatinine Drug Therapy Combination Female Drug Monitoring business Biomarkers Immunosuppressive Agents |
| Zdroj: | Transplantation. 100:203-209 |
| ISSN: | 0041-1337 |
| Popis: | Outcome after renal transplantation depends on patient compliance and adherence for early detection of complications and identification of intervention opportunities. Compliance describes the degree to which patients follow medical advice and take their medications. Adherence has been defined as the extent to which a patients' behavior coincides with clinical prescriptions.Patients were randomized 7 to 14 days after transplantation into groups with (n = 40) and without (n = 40) an electronic medication dispenser (EMD). The EMD, which was used for the 1-year study period, recorded the date and time the patient took their medications and was monitored via a web-based application. Patients were monitored for 1 year regarding outpatient follow-up visits, emergency hospitalizations, renal biopsies, rejection episodes, renal function, and blood concentration of medications.Compliance in the intervention group was 97.8% (the control group was not assessed). Number of missed doses varied significantly by weekday (P = 0.033); patients were most likely to miss doses on Saturdays and Thursdays. Patients missed a total of 11 follow-up visits. During the study, 92 biopsies were performed on 55 patients (intervention group: 32 [17]; control group, 60 [38]). Biopsy-verified rejection was three times more common among controls (13 patients vs. 4; P = 0.054, not significant). Average P-creatinine level was slightly lower in the intervention group than the control group (131 vs. 150 μmol/L, not significant), whereas mean tacrolimus was similar (7.32 vs. 7.22 ng/mL, n.s.).The EMD is associated with high compliance, and there are also indications of a lower rejection rate. |
| Databáze: | OpenAIRE |
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