Transplant Trial Watch

Self-Monitoring Kidney Function Post Transplantation: Reliability of Patient-Reported Data.

van Lint C, Wang W, et al.

Journal of Medical Internet Research 2017; 19(9): e316.

To determine the level of adherence of kidney transplant patients to a creatinine monitoring schedule using a Web-based self-management support system (SMSS), the reliability of those registered creatinine values and whether patients adhered to the system’s instructions.

Participants were randomised to either the control or intervention group. Those assigned to the intervention received a StatSensor Xpress-i Creatinine Meter for self-monitoring creatinine, a Microlife WatchBP Home for blood pressure self-measurement and access to a Web-based SMSS.

65 Dutch speaking patients with internet access who were about to receive a donor kidney (or recently received one), aged ≥18 years with a creatinine level of ≤300 μmol/l within 4 weeks post transplantation.

Measured outcomes included adherence to measurement frequency, moment of registration, correctness and representativeness of registered data, and adherence to feedback.

12 months

CET Conclusions
This study looked at the adherence of kidney transplant recipients to a self-monitoring creatinine schedule, the reliability of creatinine values that were registered by patients in a web-based self-management support system and whether patient adhered to subsequent system instructions for further actions. This report describes patients who were randomised to the self-monitoring intervention arm of a randomised controlled trial. Patients in the trial were randomised according to a randomisation schedule using allocation concealment. No power analysis was reported. Sixty-five patients were randomised to the self-monitoring study arm of which 43 (66%) performed and registered measurements throughout the study. Adherence to the requested measurement frequency during the first month was 75% which increased to 90% for months 2-4. Adherence to system instructions for further actions ranged from 53%-85% with delayed registration of measurements by patients being one of the reasons for non-adherence. Some patients also had the tendency to register more favourable values for registration. The authors caution that this should be considered when designing self-monitoring systems.

Jadad score

Data analysis
Available case analysis

Allocation concealment

Trial registration
Dutch Trial Register - NTR3548

Funding source
Non-industry funded