ICT-based adherence monitoring in kidney transplant recipients: a randomized controlled trial.Jung, H. Y., et al.
BMC Medical Informatics & Decision Making 2020; 20(1): 105.
The aim of this study was to assess whether an information and communication technology (ICT)-based centralized monitoring system could improve medication adherence among Korean renal transplant recipients.
Participants were randomized to either the ICT-based centralized clinical trial monitoring arm or the ambulatory follow-up arm.
114 kidney transplant recipients.
The primary endpoint was medication adherence (dose-taking adherence, dose frequency adherence, dose interval adherence and drug holidays). The secondary endpoints were transplant outcomes and patient satisfaction with the ICT-based monitoring system.
This is a very interesting study of a centralised monitoring system for medication adherence. Both patients and medical staff in the study arm were alerted with texts and pill box alarms if there was a missed dose. The method of randomisation is not described, so we cannot comment on it. Also the study participants and clinicians were not blinded to the study allocation. The follow up was 6 months, which should be long enough to identify any differences. The overall baseline adherence was very high, which reduced the potential impact of the introduced system. Both groups had >98% adherence throughout the study period. There is also no power calculation presented, so it is highly likely that the study was underpowered to identify any difference. Given the high adherence it is unsurprising that there were no differences between the groups in tacrolimus trough levels, mycophenolate trough levels or renal function. There was high patient satisfaction in terms of convenience and accuracy of the system. It would be interesting to see this system applied to the highest risk groups for non-adherence.
ClinicalTrials.gov - NCT03136588