&lt;p&gt;Effect and features of information technology-based interventions on self-management in adolescent and young adult kidney transplant recipients: a systematic review&lt;/p&gt;

Ganjali, Raheleh; Khoshrounejad, Farnaz; Habibi, Mohammad Reza Mazaheri; Taherzadeh, Zhila; Golmakani, Reza; Mostafavi, Sayyed Mostafa; Eslami, Saeid

doi:10.2147/ahmt.s200801

Cited by 9 publications

(12 citation statements)

References 45 publications

(57 reference statements)

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“…Interventions to structure medication-taking are needed, since adherence is worse on the weekend [ 49 ]. Among young adults, information technology-based interventions show promise in improving care process self-management outcomes, but their effect on clinical outcomes is less certain [ 50 ]. Furthermore, developmentally appropriate interventions will need to be considered for this age-range.…”

Section: Discussionmentioning

confidence: 99%

Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

et al. 2020

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Background Although young adulthood is associated with transplant loss, many studies do not examine eGFR decline. We aimed to establish clinical risk factors to identify where early intervention might prevent subsequent adverse transplant outcomes. Methods Retrospective cohort study using UK Renal Registry and UK Transplant Registry data, including patients aged < 30 years transplanted 1998–2014. Associations with death-censored graft failure were investigated with multivariable Cox proportional hazards. Multivariable linear regression was used to establish associations with eGFR slope gradients calculated over the last 5 years of observation per individual. Results The cohort (n = 5121, of whom n = 371 received another transplant) was 61% male, 80% White and 36% had structural disease. Live donation occurred in 48%. There were 1371 graft failures and 145 deaths with a functioning graft over a 39,541-year risk period. Median follow-up was 7 years. Fifteen-year graft survival was 60.2% (95% CI 58.1, 62.3). Risk associations observed in both graft loss and eGFR decline analyses included female sex, glomerular diseases, Black ethnicity and young adulthood (15–19-year and 20–24-year age groups, compared to 25–29 years). A higher initial eGFR was associated with less risk of graft loss but faster eGFR decline. For each additional 10 mL/min/1.73m2 initial eGFR, the hazard ratio for graft loss was 0.82 (95% CI 0.79, 0.86), p < 0.0001. However, compared to < 60 mL/min/1.73m2, higher initial eGFR was associated with faster eGFR decline (> 90 mL/min/1.73m2; − 3.55 mL/min/1.73m2/year (95% CI -4.37, − 2.72), p < 0.0001). Conclusions In conclusion, young adulthood is a key risk factor for transplant loss and eGFR decline for UK children and young adults. This study has an extended follow-up period and confirms common risk associations for graft loss and eGFR decline, including female sex, Black ethnicity and glomerular diseases. A higher initial eGFR was associated with less risk of graft loss but faster rate of eGFR decline. Identification of children at risk of faster rate of eGFR decline may enable early intervention to prolong graft survival.

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Section: Discussionmentioning

confidence: 99%

Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

et al. 2020

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“… Computer systems, which enable the patient to record and transmit data and through the internet. Multi-component tools, which is a combination of more than one tool from the above mentioned tools [ 27 – 29 ]. …”

Section: Methodsmentioning

confidence: 99%

“…Multi-component tools, which is a combination of more than one tool from the above mentioned tools [ 27 – 29 ].…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of IT-based interventions on self-management in adult kidney transplant recipients: a systematic review

Eslami

Khoshrounejad

Golmakani

et al. 2021

BMC Med Inform Decis Mak

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Background Kidney transplant outcomes are broadly associated with transplant recipients’ capacity in following a complex and continuous self-management regimen. Health information technology has the potential to empower patients. This systematic review aimed to determine the impacts of IT-based interventions for self-management in kidney transplant recipients. Methods A comprehensive investigation was performed in MEDLINE (via PubMed) and EMBASE (via Scopus) in April 2019. Eligible studies were the randomized controlled trials which aimed to design an automated IT-based intervention. All English papers including adult kidney transplant recipients were included. To assess the clinical trial’s quality, Cochrane Collaboration’s assessment tool was employed. The articles were integrated based on category of outcomes, characteristics of interventions, and their impact. The interventions were classified based on the used IT-based tools, including smart phones, coverage tools, computer systems, and a combination of several tools. The impact of interventions was defined as: (1) positive effect (i.e. statistically significant), and (2) no effect (i.e. not statistically significant). Results A total of 2392 articles were retrieved and eight publications were included for full-text analysis. Interventions include those involving the use of computerized systems (3 studies), smart phone application (3 studies), and multiple components (2 studies). The studies evaluated 30 outcomes in total, including 24 care process and 6 clinical outcomes. In 18 (80%) out of 30 outcomes, interventions had a statistically significant positive effect, 66% in process and 33% in clinical outcomes. Conclusions IT-based interventions (e.g. mobile health applications, wearable devices, and computer systems) can improve self-management in kidney transplant recipients (including clinical and care process outcomes). However, further evaluation studies are required to quantify the impact of IT-based self-management interventions on short- and long-term clinical outcomes as well as health care costs and patients' quality of life.

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“…Mobile health can serve as an adjuvant method for delivering health education information, sending reminders to patients to take their medicine, and implementing online education. A systematic review indicated that information technology-based interventions such as mobile health/personal digital assistants (PDAs), computer systems, and multi-components have the potential to improve selfmanagement in adolescents and young adult kidney transplant recipients (Ganjali et al, 2019). However, due to the limited number of studies and absence of sufficient data, our meta-analysis did not find significant results demonstrating that interventions together with mobile health or electronic monitoring were more effective than the routine intervention.…”

Section: Summary Of Main Findingsmentioning

confidence: 64%

Efficacy of Adherence-Enhancing Interventions for Immunosuppressive Therapy in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

Shi

Liu

et al. 2020

Front. Pharmacol.

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Background: Immunosuppressant non-adherence is a widespread problem among solid organ recipients. With the newly published clinical trials, the randomized controlled trials (RCTs) based systematic review of adherence-enhancing interventions on immunosuppressant adherence in solid organ recipients has not been completed. In this systematic review and meta-analysis, we compared the efficacy of adherenceenhancing interventions versus routine intervention, as performed with RCTs, on immunosuppressant adherence in solid organ transplantation recipients.Methods: PubMed, Embase, Cochrane Library, CINAHL full text, and PsycINFO were searched from database inception to December 2019. This review was conducted following the PRISMA's reporting guidelines and according to the principles recommended by Cochrane Handbook for Systematic Review.Results: The search yielded 10,479 articles. A total of 27 articles (26 studies) with 715 participants were included in our analysis. Results from the meta-analysis revealed that as compared with that of the routine intervention group, the rates of overall adherence, dosing adherence, and timing adherence were significantly increased within the adherence-enhancing intervention group, with the pooled risk ratio (RR) of overall adherence = 1.17, [95% confidence interval (CI): 1.07 to 1.28; p = 0.0006]; RR of dosing adherence = 1.21 (95% CI: 1.08 to 1.36, p = 0.001); RR of timing adherence = 1.16 (95% CI: 1.03 to 1.29, p = 0.01). There was a significantly increased adherence score in the adherence-enhancing intervention group; however, no statistical significance on the immunosuppressant blood concentration was found between the two study groups.

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<p>Effect and features of information technology-based interventions on self-management in adolescent and young adult kidney transplant recipients: a systematic review</p>

Cited by 9 publications

References 45 publications

Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

Effectiveness of IT-based interventions on self-management in adult kidney transplant recipients: a systematic review

Efficacy of Adherence-Enhancing Interventions for Immunosuppressive Therapy in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

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