Electronic Pillbox May Improve Adherence To Complicated Medication Regime

MedicalResearch.com Interview with:

Bethany J. Foster, MD MSCE Montreal Children’s Hospital Department of Pediatrics,  Department of Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, QC, Canada

Dr. Foster

Bethany J. Foster, MD MSCE
Montreal Children’s Hospital
Department of Pediatrics,
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University, Montreal, QC, Canada

MedicalResearch.com: What is the background for this study?

Response: Adolescent and young adult kidney transplant recipients have the highest risk of graft loss of any age group. One of the main reasons for this is not taking their anti-rejection medications as prescribed. Our study had the goal of testing an intervention to try to improve young patients’ adherence to their strict medication schedule. The intervention included feedback of how well they were taking their medications (which was monitored electronically), text message reminders for medication doses, and individualized coaching to address their personal barriers to taking their medications.

 MedicalResearch.com: What are the main findings?

Response: We found that patients who had received the intervention took their medications more consistently and more consistently on time than those who did not get the intervention.

MedicalResearch.com: What should readers take away from your report? 

Response: Our study showed that it is possible to help young people who need long term medications to take them on time every time — and that we can use technology to help with this. For people with kidney transplants, this is likely to lead to better survival of the transplanted kidney and better health overall.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Even though our intervention worked, the electronic pillbox we used was not ideal for active, young people. It was too big and not portable. In addition, we still need to figure out how to make this intervention part of usual clinical care. We are now conducting a new study called TAKE-IT TOO (takeittoo.org) in which we are working with patients, parents and healthcare professionals — and in partnership with Vaica Medical, the company that makes the electronic pillbox — to design a better, portable pillbox specifically for young people. We are also working to adapt the intervention so that it can be delivered in the clinic by the doctors and nurses taking care of these patients.

MedicalResearch.com: Is there anything else you would like to add?

Response: There is a lot of work left to do to improve outcomes for transplant recipients. A lot of great work is going on through the Canadian National Transplant Research Program (www.cntrp.ca)

Disclosures: Both the TAKE-IT study and the new study (TAKE-IT TOO) are funded by the U.S. National Institutes of Health.

Citations:

A Randomized Trial of a Multicomponent Intervention to Promote Medication Adherence: The Teen Adherence in Kidney Transplant Effectiveness of Intervention Trial (TAKE-IT)

Bethany J. Foster, Ahna L.H. Pai, Nataliya Zelikovsky, Sandra Amaral, Lorraine Bell, Vikas R. Dharnidharka, Diane Hebert, Crystal Holly, Baerbel Knauper, Douglas Matsell, Veronique Phan, Rachel Rogers, Jodi M. Smith, Huaqing Zhao, Susan L. Furth

DOI: https://doi.org/10.1053/j.ajkd.2017.12.012
Publication stage: In Press Corrected Proof
Published online: March 27, 2018

 

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