Renal transplant patient acceptance of a self-management support system

Wang, Wenxin; Lint, Céline L van; Brinkman, Willem‐Paul; Rövekamp, Ton J. M.; Dijk, S. van; Boog, Paul J.M. van der; Neerincx, Mark A.

doi:10.1186/s12911-017-0456-y

Cited by 20 publications

(16 citation statements)

References 47 publications

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“…It is therefore likely that the current findings provide a conservative estimate of the true incidence of nonadherence and inaccuracy. In line with this, patients reported very strong intentions to engage in self-monitoring both at the start and after 4 months into the trial [ 38 ]. Their intention was found to be especially associated with their overall affective reaction toward using the system [ 38 ].…”

Section: Discussionmentioning

confidence: 84%

“…In line with this, patients reported very strong intentions to engage in self-monitoring both at the start and after 4 months into the trial [ 38 ]. Their intention was found to be especially associated with their overall affective reaction toward using the system [ 38 ]. A considerable number of eligible patients had to be contacted to inform whether they were interested in study participation instead of giving informed consent immediately.…”

Section: Discussionmentioning

confidence: 84%

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

Lint¹,

Wang²,

Dijk³

et al. 2017

J Med Internet Res

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BackgroundThe high frequency of outpatient visits after kidney transplantation is burdensome to both the recovering patient and health care capacity. Self-monitoring kidney function offers a promising strategy to reduce the number of these outpatient visits.ObjectiveThe objective of this study was to investigate whether it is safe to rely on patients’ self-measurements of creatinine and blood pressure, using data from a self-management randomized controlled trial.MethodsFor self-monitoring creatinine, each participant received a StatSensor Xpress-i Creatinine Meter and related test material. For self-monitoring blood pressure, each participant received a Microlife WatchBP Home, an oscillometric device for blood pressure self-measurement on the upper arm. Both devices had a memory function and the option to download stored values to a computer. During the first year post transplantation, 54 patients registered their self-measured creatinine values in a Web-based Self-Management Support System (SMSS) which provided automatic feedback on the registered values (eg, seek contact with hospital). Values registered in the SMSS were compared with those logged automatically in the creatinine device to study reliability of registered data. Adherence to measurement frequency was determined by comparing the number of requested with the number of performed measurements. To study adherence to provided feedback, SMSS-logged feedback and information from the electronic hospital files were analyzed.ResultsLevel of adherence was highest during months 2-4 post transplantation with over 90% (42/47) of patients performing at least 75% of the requested measurements. Overall, 87.00% (3448/3963) of all registered creatinine values were entered correctly, although values were often registered several days later. If (the number of) measured and registered values deviated, the mean of registered creatinine values was significantly lower than what was measured, suggesting active selection of lower creatinine values. Adherence to SMSS feedback ranged from 53% (14/24) to 85% (33/39), depending on the specific feedback.ConclusionsPatients’ tendency to postpone registration and to select lower creatinine values for registration and the suboptimal adherence to the feedback provided by the SMSS might challenge safety. This should be well considered when designing self-monitoring care systems, for example by ensuring that self-measured data are transferred automatically to an SMSS.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 84%

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

Lint¹,

Wang²,

Dijk³

et al. 2017

J Med Internet Res

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“…Future directions of research should focus on deepening all those factors (self-efficacy, awareness disease, social and family support, health education) that influence the transplant preparation pathway and post-transplant results (32,80). Furthermore, the development of interdisciplinary interventions with the various specialists (surgeon, nephrologist, psychiatrist and psychologist) would be desirable to identify shared operational protocols for integrated care of the transplanted patient and also plan training and updating courses for the "health team" with particular attention to psychological, communicative and relational aspects (24,62,64,67,68,70,(75)(76)(77).…”

Section: Discussionmentioning

confidence: 99%

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more indepth knowledge of the candidate to plan coping strategies and possible posttransplant psychotherapy.

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“…When the CKD is diagnosed in less advanced stages, it is possible to reduce the need for dialysis and kidney transplantation, which consequently improves the quality of life of patients. A healthcare app may be used to monitor risk factors, record test results for CKD early diagnosis, and assist patients to follow the disease progression [ 16 ]. Considering a specific scenario, mobile health (mHealth) apps that generate personal health records (PHR) may be used to decrease problems related to primary healthcare at remote locations.…”

Section: Introductionmentioning

confidence: 99%

Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries

Sobrinho

Silva

Perkusich

et al. 2018

BMC Med Inform Decis Mak

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BackgroundThe chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression.MethodsA user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016. In-depth interviews and prototyping were conducted along with healthcare professionals throughout the requirements elicitation process. Elicited requirements were translated into a native mHealth app targeting the Android platform. Afterward, the Cohen’s Kappa coefficient statistics was applied to evaluate the agreement between the app and three nephrologists who analyzed test results collected from 60 medical records. Finally, eight users tested the app and were interviewed about usability and user perceptions.ResultsA mHealth app was designed to assist the CKD early diagnosis and self-monitoring considering quality attributes such as safety, effectiveness, and usability. A global Kappa value of 0.7119 showed a substantial degree of agreement between the app and three nephrologists. Results of face-to-face interviews with target users indicated a good user satisfaction. However, the task of CKD self-monitoring proved difficult because most of the users did not fully understand the meaning of specific biomarkers (e.g., creatinine).ConclusionThe UCD approach provided mechanisms to develop the app based on the real needs of users. Even with no perfect Kappa degree of agreement, results are satisfactory because it aims to refer patients to nephrologists in early stages, where they may confirm the CKD diagnosis.

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Renal transplant patient acceptance of a self-management support system

Cited by 20 publications

References 47 publications

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

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

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries

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