An Exploratory Correlational Study in the Use of Mobile Technology Among Adult Kidney Transplant Recipients

Introduction: Rapidly growing use of mobile technology provides a platform for self-management of care support for those with chronic conditions. Few studies have explored the characteristics or access patterns of kidney transplant recipients who use mHealth applications (apps) for self-management of care. Research Questions: The primary aim of this study was to describe demographics, use, barriers, and perceptions of mobile apps for self-management of care among adult kidney transplants recipients. The secondary aim was to compare blood urea nitrogen, glomerular filtration rate, and number of hospitalizations among mHealth app users, other app users, and non-app users. Methods: A cross-sectional design was used to administer the Mobile Application Use among Kidney Transplant Recipients Questionnaire. Descriptive statistics, χ2 statistics, and analysis of variance were used for the primary aim and linear regression was used for the secondary aim. Results: The sample included mostly African American males (n = 123, 75.5%) with a mean age of 50 (13.2) years. Knowledge was the greatest barrier reported by the non-app users (mHealth app users 9%, other app users 12%, non-app users, 49%, P < .001). Significantly fewer hospitalizations were found in the mHealth app users compared to other app users (regression coefficient b = −1.2, standard error [SE] = 0.5) and non-app users ( b = −0.9, SE = 0.6), adjusting for patient demographic and clinical characteristics. Discussion: Findings suggest a relationship may exist between mHealth app use and a decrease in the number of hospitalizations following kidney transplantation.

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Effect and features of information technology-based interventions on self-management in adolescent and young adult kidney transplant recipients: a systematic review

Adolescent Health Medicine and Therapeutics ◽

10.2147/ahmt.s200801 ◽

2019 ◽

Vol Volume 10 ◽

pp. 173-190 ◽

Cited By ~ 3

Author(s):

Raheleh Ganjali ◽

Farnaz Khoshrounejad ◽

Mohammad Reza Mazaheri Habibi ◽

Zhila Taherzadeh ◽

Reza Golmakani ◽

...

Keyword(s):

Systematic Review ◽

Information Technology ◽

Young Adult ◽

Kidney Transplant ◽

Adolescent And Young Adult ◽

Self Management ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Adult Kidney

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Effectiveness of IT-based interventions on self-management in adult kidney transplant recipients: a systematic review

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01360-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saeid Eslami ◽

Farnaz Khoshrounejad ◽

Reza Golmakani ◽

Zhila Taherzadeh ◽

Fariba Tohidinezhad ◽

...

Keyword(s):

Systematic Review ◽

Clinical Outcomes ◽

Kidney Transplant ◽

Care Process ◽

Self Management ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Adult Kidney ◽

The Impact ◽

Positive Effect

Abstract Background Kidney transplant outcomes are broadly associated with transplant recipients’ capacity in following a complex and continuous self-management regimen. Health information technology has the potential to empower patients. This systematic review aimed to determine the impacts of IT-based interventions for self-management in kidney transplant recipients. Methods A comprehensive investigation was performed in MEDLINE (via PubMed) and EMBASE (via Scopus) in April 2019. Eligible studies were the randomized controlled trials which aimed to design an automated IT-based intervention. All English papers including adult kidney transplant recipients were included. To assess the clinical trial’s quality, Cochrane Collaboration’s assessment tool was employed. The articles were integrated based on category of outcomes, characteristics of interventions, and their impact. The interventions were classified based on the used IT-based tools, including smart phones, coverage tools, computer systems, and a combination of several tools. The impact of interventions was defined as: (1) positive effect (i.e. statistically significant), and (2) no effect (i.e. not statistically significant). Results A total of 2392 articles were retrieved and eight publications were included for full-text analysis. Interventions include those involving the use of computerized systems (3 studies), smart phone application (3 studies), and multiple components (2 studies). The studies evaluated 30 outcomes in total, including 24 care process and 6 clinical outcomes. In 18 (80%) out of 30 outcomes, interventions had a statistically significant positive effect, 66% in process and 33% in clinical outcomes. Conclusions IT-based interventions (e.g. mobile health applications, wearable devices, and computer systems) can improve self-management in kidney transplant recipients (including clinical and care process outcomes). However, further evaluation studies are required to quantify the impact of IT-based self-management interventions on short- and long-term clinical outcomes as well as health care costs and patients' quality of life.

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Changes in quality of life (QoL) and other patient-reported outcome measures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews

BMJ Open ◽

10.1136/bmjopen-2020-047263 ◽

2021 ◽

Vol 11 (4) ◽

pp. e047263

Author(s):

Andrea Gibbons ◽

Janet Bayfield ◽

Marco Cinnirella ◽

Heather Draper ◽

Rachel J Johnson ◽

...

Keyword(s):

Kidney Transplant ◽

Outcome Measures ◽

Deceased Donor ◽

Patient Reported Outcome Measures ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Structured Interviews ◽

Cross Sectional ◽

Post Transplant ◽

Patient Reported

ObjectiveTo examine quality of life (QoL) and other patient-reported outcome measures (PROMs) in kidney transplant recipients and those awaiting transplantation.DesignLongitudinal cohort questionnaire surveys and qualitative semi-structured interviews using thematic analysis with a pragmatic approach.SettingCompletion of generic and disease-specific PROMs at two time points, and telephone interviews with participants UK-wide.Participants101 incident deceased-donor (DD) and 94 incident living-donor (LD) kidney transplant recipients, together with 165 patients on the waiting list (WL) from 18 UK centres recruited to the Access to Transplantation and Transplant Outcome Measures (ATTOM) programme completed PROMs at recruitment (November 2011 to March 2013) and 1 year follow-up. Forty-one of the 165 patients on the WL received a DD transplant and 26 received a LD transplant during the study period, completing PROMs initially as patients on the WL, and again 1 year post-transplant. A subsample of 10 LD and 10 DD recipients participated in qualitative semi-structured interviews.ResultsLD recipients were younger, had more educational qualifications and more often received a transplant before dialysis. Controlling for these and other factors, cross-sectional analyses at 12 months post-transplant suggested better QoL, renal-dependent QoL and treatment satisfaction for LD than DD recipients. Patients on the WL reported worse outcomes compared with both transplant groups. However, longitudinal analyses (controlling for pre-transplant differences) showed that LD and DD recipients reported similarly improved health status and renal-dependent QoL (p<0.01) pre-transplant to post-transplant. Patients on the WL had worsened health status but no change in QoL. Qualitative analyses revealed transplant recipients’ expectations influenced their recovery and satisfaction with transplant.ConclusionsWhile cross-sectional analyses suggested LD kidney transplantation leads to better QoL and treatment satisfaction, longitudinal assessment showed similar QoL improvements in PROMs for both transplant groups, with better outcomes than for those still wait-listed. Regardless of transplant type, clinicians need to be aware that managing expectations is important for facilitating patients’ adjustment post-transplant.

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