Introduction: Adhered to immunosuppressive medication after solid organ transplantation is a crucial issue requires a personalized approach to rectify non-compliant behaviors. Global digitalization and the increasing uses of technology into daily life has raised raise an opportunity to utilize technology to improve patient outcomes. The widespread use of smartphones and mobile applications, particularly for the provision of timely reminders to patients, represents a promising approach to augmenting adherence to treatment protocols. This study aims to assess the benefit of mobile application usage on medication adherence among the liver and kidney transplant recipients.
Methods: The eligible participants were randomly assigned to either the intervention (IG) or control (CG) group for post-transplant care. The intervention group (IG) utilized a mobile application alongside Bluetooth devices to facilitate daily monitoring and cloud-based record uploads of medication consumption. In contrast, the control group (CG) received standardized medication education. Assessments were conducted at the 12-week and 24-week, encompassing the calculation of medication adherence rates, completion of a self-report questionnaire and intra-patient variability (IPV) of tacrolimus trough level.
Results: One hundred and two patients were recruited and 49 remained in IG group and 53 in CG group. We analyzed the tacrolimus IPV between the two groups was 0.36 and 0.16 at 12-week and 24-week, no significant difference (p=.896; p=.726) was observed. The medication adherence scores of IG increased from 0.93 to 0.98 and 0.98 (p<.001; p<.001), whereas scores of CG group increased from 0.93 to 0.95 and then to 0.96 (p=.014; p<.001). In addition, adherence to clinical appointment in IG is significantly higher than the CG group (p=.008; p=.030). Change scores of the Immunosuppressant Therapy Adherence Scale (ITAS) between the two groups was 0.36 and 0.49 at 12-week and 24-week, respectively, no significant difference (p=.099; p=.087) was observed. Notably, medication reminder functions are more utilized in kidney transplant patients (55%) compare to liver transplant patients (35%).
Conclusions: Mobile applications are proven effective in enhancing immunosuppressant medication adherence, with Bluetooth-enabled devices offering more reliable adherence metrics than self-reports. Accurate monitoring is crucial, especially as kidney transplant recipients show lower adherence compared to liver transplant patients, both objectively and subjectively. The integration of mobile technology for medication reminders and usage monitoring promises to improve adherence among transplant recipients. This approach could significantly enhance post-transplant care outcomes by ensuring patients consistently follow their medication regimens, highlighting the potential of technology-driven solutions in healthcare to optimize treatment compliance and patient well-being.