Transplant Regimen Adherence for Kidney Recipients by Engaging Information Technologies: The TAKE IT Trial
通过利用信息技术提高肾受者的移植方案依从性:TAKE IT 试验
基本信息
- 批准号:9309767
- 负责人:
- 金额:$ 66.84万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-04-04 至 2021-03-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdverse effectsAdverse eventAffectBlood PressureCare given by nursesCaringChronic DiseaseClinicClinicalComplexDisease OutcomeEffectivenessElectronic Health RecordEvaluationFamilyFutureGlycosylated hemoglobin AHealthHealth systemHealthcare SystemsHospitalizationIndividualInformation TechnologyInterventionInterviewKidneyKidney TransplantationKnowledgeLDL Cholesterol LipoproteinsLiving DonorsLongitudinal StudiesMedical Care TeamMedical StaffMedicineModificationMonitorMotivationNatureOnline SystemsOrgan TransplantationOutcomePatient MonitoringPatient Self-ReportPatientsPersonsPharmaceutical PreparationsPharmacistsPharmacy facilityPlant RootsProcessProviderPublic HealthQuality of lifeRandomized Controlled TrialsRecordsRecruitment ActivityRegimenReportingResearchResourcesRiskScheduleSiteSocial WorkersSocial supportTacrolimusTechnologyTelephone InterviewsTestingTextTimeTouch sensationTransplant RecipientsTransplantationUnited States National Institutes of HealthUniversitiesarmcompliance behaviorcostdesigneffective therapyefficacy testingfollow-upgraft failurehealth service useimprovedintervention effectmedication compliancemobile computingnovelpillsuccessful interventiontreatment as usual
项目摘要
PROJECT SUMMARY
We will evaluate a technology-enabled strategy designed to promote medication adherence, routinely
monitor regimen use, and mobilize appropriate transplant center resources to respond early to kidney
transplant (KT) recipients demonstrating inadequate adherence. Medication non-adherence is a leading
root cause of graft failure, and KT recipients have the highest reported rate of poor adherence (~35%) among
all organ transplant recipients. Despite many attempts, there have been few successful interventions evaluated
to date that have significantly improved KT recipients' regimen adherence and subsequent health outcomes
over time. Using evidence from our research team's extensive previous studies in other chronic disease
contexts, we will implement and comprehensively test a low cost, `low touch', thus highly scalable intervention:
the Transplant regimen Adherence for Kidney recipients by Engaging Information Technologies (TAKE IT)
strategy. The TAKE IT strategy leverages a transplant center's electronic health record a web-based patient
portal, and mobile technology to: 1) educate patients on their prescribed Rx regimens, 2) help them organize
their daily regimen schedule in the most efficient manner, 3) remind them via SMS text when to take their
medicine, 4) routinely monitor regimen use, and 5) provide care alerts to engage appropriate transplant center
clinical staff (e.g. pharmacist, social worker, nurse care coordinator) when medication concerns are detected.
All components of the TAKE IT strategy have been developed with prior NIH support, refined with `user' input
(patient, family, clinic staff), and their efficacy tested in non-transplant settings. Our primary aim is to: 1) test
the effectiveness of the TAKE IT strategy, compared to usual care, to improve KT recipients' treatment
knowledge, medication use, transplant-specific and chronic disease outcomes. Our secondary aims are to:
2) examine the persistence of any effects of the TAKE IT strategy on outcomes over 2 years among new and
established KT recipients, 3) evaluate the fidelity of each component of the TAKE IT strategy over time, and
investigate any patient, provider, or transplant center barriers to implementation, and 4) determine the costs of
delivering the TAKE IT strategy from a transplant center perspective. We will conduct a 2-arm, patient-
randomized controlled trial at two large, diverse transplant centers (Northwestern University; Mayo Clinic). 300
KT recipients within 3 months of transplant (`de novo') and 400 `established' patients between 18 and 36
months post-KT will be recruited and followed for 2 years. In-person interviews will be conducted at baseline,
6, 12, 18 and 24 months. Electronic health and pharmacy records will be ascertained to capture medication
adherence and clinical outcomes. Additionally, our team will closely evaluate the implementation of all
components of the TAKE IT strategy from launch through 2 years follow-up. We will further inform future
dissemination efforts by estimating the incremental costs of implementing and sustaining the TAKE IT strategy
from the perspective of two transplant centers.
项目总结
我们将定期评估旨在促进服药依从性的技术支持战略
监测方案的使用,并调动适当的移植中心资源以及早对肾脏做出反应
移植(KT)受者表现出不充分的依从性。用药不依从性是主要的
移植物失败的根本原因,KT接受者报告的粘附率最高(~35%)
所有器官移植受者。尽管进行了多次尝试,但很少有成功的干预措施得到评估
到目前为止,已经显著改善了KT接受者的方案依从性和随后的健康结果
随着时间的推移。使用我们研究团队先前对其他慢性疾病进行的广泛研究中的证据
在这种情况下,我们将实施并全面测试一种低成本、低接触,从而具有高度可扩展性的干预措施:
利用信息技术对肾移植患者移植方案的依从性(Take IT)
策略。Take IT策略利用移植中心基于网络的患者的电子健康记录
门户和移动技术:1)教育患者了解他们的处方Rx方案;2)帮助他们组织
他们的日常养生计划以最有效的方式进行,3)通过短信提醒他们何时服用
药物,4)常规监测方案的使用,5)提供护理警报,以联系适当的移植中心
临床工作人员(如药剂师、社会工作者、护士护理协调员)在检测到用药问题时。
Take IT战略的所有组成部分都是在NIH先前的支持下开发的,并通过用户输入进行了改进
(患者、家属、诊所工作人员),并在非移植环境中测试其疗效。我们的主要目标是:1)测试
与常规护理相比,Take IT战略在改善KT接受者治疗方面的有效性
知识、用药情况、特定移植和慢性病结果。我们的次要目标是:
2)检查Take IT战略在两年内对新员工和
确定的KT接受者,3)评估随时间推移Take IT战略的每个组件的保真度,以及
调查任何患者、提供商或移植中心实施的障碍,并4)确定
从移植中心的角度提供Take IT战略。我们将进行双臂手术,病人-
在两个不同的大型移植中心(西北大学和梅奥诊所)进行的随机对照试验。300人
移植后3个月内接受KT的患者(“新”)和400名18至36岁的“已确诊”患者
在KT之后的几个月将被招募,并跟踪两年。面谈将在基线上进行,
6个月、12个月、18个月和24个月。电子健康和药房记录将被确定以获取药物
依从性和临床结果。此外,我们的团队将密切评估所有
从启动到两年跟踪的Take IT战略的组成部分。我们将进一步通知未来
通过估计实施和维持Take IT战略的增量成本来进行传播工作
从两个移植中心的角度来看。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Daniela P Ladner其他文献
Transforming the Future of Surgeon-Scientists
改变外科医生科学家的未来
- DOI:
- 发表时间:
2023 - 期刊:
- 影响因子:9
- 作者:
Daniela P Ladner;Allan M. Goldstein;Tim Billiar;Andrew M Cameron;Darren R Carpizo;Daniel I Chu;Craig M Coopersmith;Ronald P DeMatteo;Sandy Feng;Katherine A Gallagher;W. Gillanders;B. Lal;G. Lipshutz;Annie Liu;Ronald V. Maier;E. Mittendorf;Arden M. Morris;J. Sicklick;O. Velazquez;Bryan A. Whitson;Lee G Wilke;Sam S Yoon;Martha A. Zeiger;Diana L Farmer;E. S. Hwang - 通讯作者:
E. S. Hwang
Daniela P Ladner的其他文献
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{{ truncateString('Daniela P Ladner', 18)}}的其他基金
Natural history, risk prediction and cost of cirrhosis in insured Americans.
受保美国人的肝硬化自然史、风险预测和费用。
- 批准号:
10346703 - 财政年份:2022
- 资助金额:
$ 66.84万 - 项目类别:
Natural history, risk prediction and cost of cirrhosis in insured Americans.
受保美国人的肝硬化自然史、风险预测和费用。
- 批准号:
10557845 - 财政年份:2022
- 资助金额:
$ 66.84万 - 项目类别:
The Northwestern Summer Research Program for Medical Students
西北医学生夏季研究计划
- 批准号:
10090216 - 财政年份:2021
- 资助金额:
$ 66.84万 - 项目类别:
LIVOPT -- LIVer cirrhosis - Optimizing Prediction of Patient OuTcomes
LIVOPT——肝硬化——优化患者结果的预测
- 批准号:
10490243 - 财政年份:2021
- 资助金额:
$ 66.84万 - 项目类别:
LIVOPT -- LIVer cirrhosis - Optimizing Prediction of Patient OuTcomes
LIVOPT——肝硬化——优化患者结果的预测
- 批准号:
10666608 - 财政年份:2021
- 资助金额:
$ 66.84万 - 项目类别:
The Northwestern Summer Research Program for Medical Students
西北医学生夏季研究计划
- 批准号:
10391427 - 财政年份:2021
- 资助金额:
$ 66.84万 - 项目类别:
Transplant Regimen Adherence for Kidney Recipients by Engaging Information Technologies: The TAKE IT Trial
通过利用信息技术提高肾受者的移植方案依从性:TAKE IT 试验
- 批准号:
9906214 - 财政年份:2017
- 资助金额:
$ 66.84万 - 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
- 批准号:
8477034 - 财政年份:2011
- 资助金额:
$ 66.84万 - 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
- 批准号:
8731865 - 财政年份:2011
- 资助金额:
$ 66.84万 - 项目类别:
A2ALL- Patient Safety System Improvements in Living Donor Liver Transplantation
A2ALL-活体肝移植中患者安全系统的改进
- 批准号:
8188248 - 财政年份:2011
- 资助金额:
$ 66.84万 - 项目类别:
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