Medication adherence is a major challenge among organ transplant recipients, and is the leading cause of graft failure among kidney and liver transplant recipients. Furthermore, studies among primary care patients have found that health literacy is an important risk factor for medication adherence, and that the use of simple, plain-language medication information can improve medication adherence. Thus far, interventions to improve medication self-management among solid organ transplant recipients have had limited success. This proposal will build upon a substantial evidence base of many individual intervention components in primary care to develop a multifaceted web portal that will serve as key infrastructure for a future, multicomponent intervention to help new organ transplant recipients engage in self-care and manage communications with health care providers. We will develop a user-centered communications tool that will leverage electronic healthcare records and common technologies (website, SMS text) to improve medication adherence among transplant recipients. We will use a community-based participatory research approach to design and develop the prototype of a web-based Transplant Patient Portal to help new transplant recipients engage in self- management of their complex medication regimens.

Public Health Relevance

Medication non adherence costs the U.S. healthcare system an estimated $300 billion a year due to increased health services use resulting from less effective treatment or adverse drug events. In the context of solid organ transplantation, this problem affects 1 in 3 transplant recipients, jeopardizing their transplant and overall health. Preventable organ loss is crucial when considering there are nearly 100,000 individuals waiting for a kidney and over 10,000 waiting for a liver; the demand for organs far exceeds the supply of living or deceased donors. Interventions are urgently needed to help new kidney transplant recipients adopt and sustain complex and dynamic medication adherence behaviors. The proposed research is relevant to public health because it will inform and direct the use of common but underutilized technology to help patients improve their medication behaviors and communication with providers and is relevant to NIH mission in that it has the potential to contribute to the healthy lives of kidney and liver transplant recipients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NR014544-01A1
Application #
8824300
Study Section
Dissemination and Implementation Research in Health Study Section (DIRH)
Program Officer
Huss, Karen
Project Start
2015-09-28
Project End
2017-07-31
Budget Start
2015-09-28
Budget End
2016-07-31
Support Year
1
Fiscal Year
2015
Total Cost
$247,509
Indirect Cost
$79,657
Name
Emory University
Department
Surgery
Type
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Patzer, Rachel E; Serper, Marina; Reese, Peter P et al. (2016) Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients. Clin Transplant 30:1294-1305