Leveraging Technology to Improve Medication Adherence in Adolescent and Young Adult Kidney or Liver Transplant Recipients: A Micro-Randomized Trial

Description

Can the investigators create an effective way to improve adherence to immunosuppressant medication and reduce rejection, graft loss, and death in adolescents and young adults who have undergone kidney or liver transplantation? The investigators' mobile technology intervention uses real-time electronic pillbox-assessed dose timing and text message prompts to address antirejection medication nonadherence when nonadherence is detected.Over 1/3 of adolescents and young adults who have undergone kidney or liver transplantation are nonadherent to antirejection medicines, accounting for shockingly high rates of infections, rejection, graft loss, and even death. Recently, the American Society of Transplantation highlighted real-time adherence intervention as top priorities to address antirejection medication nonadherence, but these evidence-based intervention tools do not exist. The investigators aim to answer the American Society of Transplantation's call and fill these critical gaps in nonad

Trial Eligibility

Inclusion Criteria: * Adolescents and young adults (13-25 years old) who underwent kidney or liver transplantation at least 6 months prior to enrollment * Currently prescribed tacrolimus or sirolimus. Exclusion Criteria: * Currently receiving dialysis * Hospitalized for duration of study * Significant developmental or cognitive delay * No access to a mobile device that supports text messaging * Decline to use electronic pill box to monitor daily medication adherence * Non-English speaking * If a participant meets inclusion criteria, enrolls in the study, and experiences graft failure potentially leading to dialysis in the case of kidney transplant recipients, the participant will be given the option to continue in the study if they remain on tacrolimus or sirolimus.

Study Info

Interventions

Locations Recruiting

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