MyKidneyCoach, Patient Activation, and Clinical Outcomes in Diverse Kidney Transplant Recipients: A Randomized Control Pilot Trial

Autor: McLean D. Pollock, PhD, MSW, Nicolas Stauffer, MB, Hui-Jie Lee, PhD, Shein-Chung Chow, PhD, Ito Satoru, BS, Lynnette Moats, RN, MSN, Sherri Swan-Nesbit, RN, MSN, Yan Li, PhD, John K. Roberts, MD, Matthew J. Ellis, MD, Clarissa J. Diamantidis, MD, Sharron L. Docherty, PhD, PNP, Eileen T. Chambers, MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Transplantation Direct, Vol 9, Iss 4, p e1462 (2023)
Druh dokumentu: article
ISSN: 2373-8731
00000000
DOI: 10.1097/TXD.0000000000001462
Popis: Background:. Kidney transplant (KT) recipients who are not actively engaged in their care and lack self-management skills have poor transplant outcomes, which are disproportionately observed among Black KT recipients. This pilot study aimed to determine whether the MyKidneyCoach app, an mHealth intervention that provides self-management monitoring and coaching, improved patient activation, engagement, and nutritional behaviors in a diverse KT population. Methods:. This was a randomized, age-stratified, parallel-group, attention-control, pilot study in post-KT patients. Participants were randomized into the attention-control with access to MyKidneyCoach for education and self-management (n = 9) or the intervention with additional tailored nurse coaching (n = 7). Feasibility, acceptability, and clinical outcomes were assessed. Results:. The acceptability of MyKidneyCoach by System Usability Scale was 67.5 (95% confidence interval [CI], 59.1-75.9). Completion rates based on actively using MyKidneyCoach were 81% (95% CI, 57%-93%) and study retention rate of 73%. Patient activation measure significantly increased overall by a mean of 11 points (95% CI, 3.2-18.8). Additionally, Black patients (n = 7) had higher nutrition self-efficacy scores of 80.5 (95% CI, 74.4-86.7) compared with 75.6 (95% CI, 71.1-80.1) in non-Black patients (n = 9) but lower patient activation measure scores of 69.3 (95% CI, 56.3-82.3) compared with 71.8 (95% CI, 62.5-81) in non-Black patients after 3 mo. Conclusions:. MyKidneyCoach was easy to use and readily accepted with low attrition, and improvements were demonstrated in patient-reported outcomes. Both Black and non-Black participants using MyKidneyCoach showed improvement in self-management competencies; thus, this intervention may help reduce healthcare inequities in KT.
Databáze: Directory of Open Access Journals
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