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Title: | Improving medication adherence in adult kidney transplantation (IMAKT): A pilot randomised controlled trial. | Authors: | Nalder M.;Kennedy E.;Smith C.L.;Yip D.;Williams A.;Low J.K.;Manias E.;Crawford K. ;Walker R.;Mulley W.R.;Toussaint N.D.;Dooley M. | Institution: | (Low, Crawford, Williams) Monash University, Clayton, VIC, Australia (Low, Manias) School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Burwood, VIC, Australia (Manias) Royal Melbourne Hospital, Parkville, VIC, Australia (Manias) Melbourne School of Health Sciences, University of Melbourne, Parkville, VIC, Australia (Walker) Department of Renal Medicine, Alfred Hospital, Melbourne, VIC, Australia (Walker) Department of Medicine, Monash University, Melbourne, VIC, Australia (Mulley, Kennedy) Department of Nephrology, Monash Medical Centre, Clayton, VIC, Australia (Mulley) Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, VIC, Australia (Toussaint, Yip) Department of Nephrology, Royal Melbourne Hospital, Parkville, VIC, Australia (Toussaint) Department of Medicine, University of Melbourne, Parkville, VIC, Australia (Dooley) Alfred Health, VIC, Australia (Dooley) Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia (Smith) School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Nalder) Pharmacy Department, Royal Melbourne Hospital, Parkville, VIC, Australia | Issue Date: | 30-Oct-2020 | Copyright year: | 2019 | Publisher: | NLM (Medline) | Place of publication: | United Kingdom | Publication information: | Scientific reports. 9 (1) (pp 7734), 2019. Date of Publication: 22 May 2019. | Journal: | Scientific Reports | Abstract: | Resources to support long-term medication adherence in kidney transplantation are limited. This study aimed to determine the efficacy of an intervention designed for kidney transplant recipients to enhance medication adherence. A single-blind, multi-site, 12-month pilot randomised controlled trial was conducted at all five public hospitals providing adult kidney transplantation in Victoria, Australia. Participants were recruited at 4 to 6 weeks post-transplantation. Thirty-five participants were randomly assigned to a 3-month intervention, involving a face-to-face meeting (a medication review and a consumer-centred video) and health coaching every two weeks. Thirty-six were randomised to receive usual care. All participants were followed for nine months post-intervention. There were no differences in adherence between groups measured by Medication Event Monitoring System (MEMS), however, it was underutilised by 42% of participants. Based on the self-reported Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©) score, the percentage of adherent participants decreased significantly between baseline and 3 to 12 months in the control group (p-values<0.001) whilst the percentage of adherent participants in the intervention group remained constant over time. No group differences were detected in other outcomes. Due to the complex medication regimen, developing and testing a medication adherence intervention is difficult in kidney transplantation. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1038/s41598-019-44002-y | PubMed URL: | 31118485 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31118485] | ISSN: | 2045-2322 (electronic) | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35508 | Type: | Article | Subjects: | clinical trial comparative study controlled study counseling female graft rejection/pc [Prevention] human *kidney transplantation male *medication compliance middle aged multicenter study patient education pilot study public hospital randomized controlled trial single blind procedure telemedicine telephone treatment outcome Victoria immunosuppressive agent/dt [Drug Therapy] tacrolimus/dt [Drug Therapy] adult audiovisual aid *medication compliance middle aged multicenter study patient education pilot study public hospital randomized controlled trial single blind procedure telemedicine telephone treatment outcome Victoria *kidney transplantation human graft rejection / prevention adult clinical trial audiovisual aid male female counseling controlled study comparative study |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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