Development and Evaluation of a Mobile Directly Observed Therapy Smartphone App for Immunosuppressive Adherence in Transplant Patients

用于移植患者免疫抑制依从性的移动直接观察治疗智能手机应用程序的开发和评估

• 批准号: 10254312
• 负责人: Cozumel Southern Pruette
• 金额: $ 72.85万
• 依托单位: EMOCHA MOBILE HEALTH, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-19 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10254312
• 关键词: Acute; Address; Adherence; American; Behavioral; Birds; Car Phone; Caregivers; Case Management; Cessation of life; Chronic Disease; Clinical; Communication; Communities; Consensus; Custom; Data; Development; Directly Observed Therapy; Dose; Early Diagnosis; Ensure; Evaluation; Feedback; Fostering; Funding; Goals; Guidelines; Health Personnel; Health Technology; Hepatitis C virus; Hospitalization; Immunosuppression; Immunosuppressive Agents; Incentives; Individual; Infrastructure; Intervention; Interview; Kidney; Kidney Transplantation; Liver; Mobile Health Application; Monitor; Motivation; National Institute of Diabetes and Digestive and Kidney Diseases; Notification; Online Systems; Organ Transplantation; Outcome; Participant; Patient Care; Patient Noncompliance; Patient Self-Report; Patients; Persuasive Communication; Pharmaceutical Preparations; Phase; Pilot Projects; Positioning Attribute; Provider; Quality of life; Randomized Controlled Trials; Recommendation; Regimen; Reporting; Schedule; Self Efficacy; Site; Societies; Solid; Standardization; Structure; Surveys; Symptoms; System; Technology; Text Messaging; Time; Transplant Recipients; Transplantation; Tuberculosis; Universities; adherence rate; age group; behavior change; cost; design; effectiveness implementation study; efficacy study; graft failure; improved; indexing; infectious disease treatment; innovation; liver transplantation; mHealth; medication compliance; medication nonadherence; mobile application; mortality; patient oriented; patient-clinician communication; phase III trial; programs; real time monitoring; side effect; smartphone Application; standard of care; symposium; tool; usability

Project Summary Outcomes following solid organ transplantation (SOT) are generally excellent with 5-year survival exceeding 85% for most graft types and age groups. Immunosuppression nonadherence is an important factor leading to graft failure and patient mortality in SOT recipients since individuals are required to make a lifelong commitment to a strict medication schedule. Nonadherence has been reported to range from 15 to 40% among liver patients and more than 30% among kidney patients. Mobile applications (“apps”) provide a low-cost and scalable opportunity to improve medication adherence through more consistent monitoring, earlier detection of nonadherence, and frequent patient-provider communication with nonadherent patients. We have developed a patient-facing mHealth app, mDOT for Transplantation, that enables patients to view their immunosuppression regimen, record themselves taking doses of their medication, track and visualize progress on their own and with their transplant coordinator, document symptoms and side effects, and access educational content. There is a transplant provider web- based platform where they can review patient submitted videos, provide feedback about accepting the video as evidence of adherence, and receive notifications when patients report symptoms. The proposed project seeks to optimize this tool to increase medication adherence in transplant recipients. The aims of the project are: 1) to enhance mDOT for Transplantation with 2-way patient-provider communication/messaging capabilities and standardized text messages to promote behavior change and 2) to perform a pilot randomized controlled trial of mDOT for Transplantation compared to standard-of-care in SOT patients.

项目概要 实体器官移植 (SOT) 的结果通常非常好，5 年生存率超过 对于大多数移植类型和年龄组来说，85% 的患者不遵守免疫抑制是导致发生这种情况的重要因素。 SOT 受者的移植失败和患者死亡率，因为个人需要终生进行移植 据报道，有 15% 至 40% 的人不遵守严格的用药计划。 肝病患者占30%以上，肾病患者占30%以上。 移动应用程序（“应用程序”）提供了低成本且可扩展的机会来提高药物依从性 通过更一致的监测、更早发现不依从性以及频繁的患者提供者 我们开发了一款面向患者的 mHealth 应用程序 mDOT。 移植，使患者能够查看他们的免疫抑制方案，记录自己的服用情况 他们的药物剂量，自己以及与移植协调员一起跟踪和可视化进展情况， 记录症状和副作用，并访问教育内容有一个移植提供商网站 - 基于平台，他们可以审查患者提交的视频，提供有关接受视频的反馈 依从性的证据，并在患者报告症状时收到通知。 拟议的项目旨在优化该工具，以提高移植受者的药物依从性。 该项目的目标是： 1) 通过双向患者-提供者增强移植的 mDOT 通信/消息功能和标准化短信，以促进行为改变，2) 进行 mDOT 移植试验与 SOT 护理标准相比的试点随机对照试验 患者。