http://sctr.musc.edu 843-792-8300 pilot feasibility clinical trial: telemedicine infused adherence...
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http://sctr.musc.edu843-792-8300
Pilot Feasibility Clinical Trial: Telemedicine Infused Adherence
Enhancement for RenalTransplant Patients
SubtitlePresenters
Date
John W McGillicuddy, MDFrank A Treiber, PhD
Martina Mueller, PhDGayenell S Magwood, PhD, RN
Gail Johnson, MSPresented: Verizon Wireless Health Technology Initiative Meeting,
Nov. 15, 2011
http://sctr.musc.edu843-792-8300
Rationale• ESRD afflicts more than 500,000 people in the USA• HTN and DM are the #1 and #2 causes of ESRD • Kidney transplantation is the treatment of choice for
ESRD• Kidneys are an incredibly scarce resource which
mandates that their use be optimized• Despite significant advances, average graft survival is
suboptimal at approximately 9 years• Graft survival is worse among African-Americans and
those of lower socioeconomic status
http://sctr.musc.edu843-792-8300
Rationale• Medication nonadherence is key contributor to
premature graft loss• Approximately 35% of renal transplant patients are
nonadherent and issues often develop within weeks of transplantation
• Medication nonadherence contributes to graft loss by allowing for immune mediated rejection and the deleterious effects of poorly controlled HTN and DM
• Mobile health technology has the potential to improve medication adherence, blood pressure and blood sugar control, and graft survival
http://sctr.musc.edu843-792-8300
Aim• Utilize wireless technology to identify nonadherent
patients early after transplant and to interact with them in real time to improve adherent behaviors as a means to improve:• Medication adherence• Control of HTN• Control of DM• Graft survival
http://sctr.musc.edu843-792-8300
Study Design and Methods• Type: Randomized control trial• Subjects: 20 nonadherent kidney transplant patients• Methods: randomly assigned to:• Group A: standard post operative care• Group B: “bundled” wireless real time
medication reminder system, blood pressure/blood glucose monitoring, cognitive behavior adherence skills enhancement program
http://sctr.musc.edu843-792-8300
Study Design and Methods• Technology• Maya MedMinder to monitor and aid in
medication adherence• Bluetooth enabled Fora D15b to measure and
record BP and blood glucose• “Smart” phones for signal transmission• “Smart” phones for patient interaction• Cognitive behavioral enhancement techniques
via video conferencing with adherence coach
http://sctr.musc.edu843-792-8300
Study Design and Methods• Outcomes (measured pre-, 1, 2, and 3 months):
• Medication adherence (Maya MedMinder)
• Blood pressure control (Fora D15b, 24h ambulatory BP)
• Blood glucose control (Fora D15b, HgbA1c)
• Immunosuppression (FK506 variability)
Content• Content
TENSION TAMER
http://sctr.musc.edu843-792-8300
Presented by the COLLEGES of NURSING
and MEDICINE