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: 10024541
• 负责人: DORRY L. SEGEV
• 金额: $ 74.47万
• 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 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10024541
• 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.

项目摘要 实体器官移植（SOT）后的结局通常很好，5年生存率超过 对于大多数移植类型和年龄组，为85%。免疫抑制不依从是导致 SOT接受者的移植失败和患者死亡率，因为个体需要进行终身的 严格的服药时间表。据报道，在这些患者中， 肝脏患者和超过30%的肾脏患者。 移动的应用程序（“app”）提供了一个低成本和可扩展的机会，以提高药物依从性 通过更一致的监测、更早地检测不依从性以及频繁的患者-提供者 与非患者沟通。我们开发了一个面向患者的移动健康应用程序，mDOT， 移植，使患者能够查看他们的免疫抑制方案，记录自己服用 他们的药物剂量，跟踪和可视化自己的进展，并与他们的移植协调员， 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， 依从性证据，并在患者报告症状时收到通知。 拟议的项目旨在优化这一工具，以提高移植受者的药物依从性。的 该项目的目标是：1）通过双向患者-提供者加强mDOT用于移植 通信/消息传递能力和标准化的文本消息，以促进行为改变，以及2） 进行一项mDOT移植与SOT标准治疗相比的初步随机对照试验 患者