Cell phone support to improve medication adherence among solid organ transplant recipients
Corresponding Author
Caitlin S. Sayegh
Children's Hospital Los Angeles, Los Angeles, CA, USA
Correspondence
Caitlin S. Sayegh, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Email: [email protected]
Search for more papers by this authorJacqueline R. Szmuszkovicz
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorJondavid Menteer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorSara Sherer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorDaniel Thomas
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorRachel Lestz
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorMarvin Belzer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorCorresponding Author
Caitlin S. Sayegh
Children's Hospital Los Angeles, Los Angeles, CA, USA
Correspondence
Caitlin S. Sayegh, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Email: [email protected]
Search for more papers by this authorJacqueline R. Szmuszkovicz
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorJondavid Menteer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorSara Sherer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorDaniel Thomas
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorRachel Lestz
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorMarvin Belzer
Children's Hospital Los Angeles, Los Angeles, CA, USA
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Search for more papers by this authorAbstract
For many adolescent and young adult solid organ transplant recipients, medication non-adherence is a mortal issue. This study investigated the feasibility, acceptability, and potential efficacy of a 12-week cell phone support intervention to improve immunosuppressant medication adherence. A small sample (N = 8) of non-adherent adolescent and young adult transplant recipients, aged 15-20.5 years, was enrolled. Cell phone support consisted of short calls each weekday including medication reminders, discussion of needs, problem-solving support, and promotion of clinic and community resources. Changes in adherence were measured by self-report and laboratory values, and intervention acceptability, adherence barriers, social support, depression, and substance use were assessed by self-report. Pre-post effect sizes showed medium-to-large improvements in adherence, lasting through a 12-week follow-up assessment. There were also small-to-medium changes in adherence barriers, social support, and depression. However, acceptability and feasibility were limited, due to a low rate of enrollment by eligible male participants. Cell phone support interventions may promote medication adherence among adolescents and young adults. Cell phone support warrants further investigation, including a randomized controlled trial to evaluate efficacy.
REFERENCES
- 1LaRosa C, Glah C, Baluarte HJ, Meyers KE. Solid-organ transplantation in childhood: transitioning to adult health care. Pediatrics. 2011; 127: 742-753.
- 2Shellmer DA, Dabbs AD, Dew MA. Medical adherence in pediatric organ transplantation: what are the next steps? Curr Opin Organ Transplant. 2011; 16: 509-514.
- 3Stuber ML. Psychiatric issues in pediatric organ transplantation. Child Adolesc Psychiatr Clin N Am. 2010; 19: 285-300.
- 4Dobbels F, Ruppar T, De Geest S, Decorte A, Damme-Lombaerts V, Fine RN. Adherence to the immunosuppressive regimen in pediatric kidney transplant recipients: a systematic review. Pediatr Transplant. 2010; 14: 603-613.
- 5Berquist RK, Berquist WE, Esquivel CO, Cox KL, Wayman KI, Litt IF. Non-adherence to post-transplant care: prevalence, risk factors and outcomes in adolescent liver transplant recipients. Pediatr Transplant. 2008; 12: 194-200.
- 6Wray J, Waters S, Radley-Smith R, Sensky T. Adherence in adolescents and young adults following heart or heart-lung transplantation. Pediatr Transplant. 2006; 10: 694-700.
- 7Stilley CS, Lawrence K, Bender A, Olshansky E, Webber SA, Dew MA. Maturity and adherence in adolescent and young adult heart recipients. Pediatr Transplant. 2006; 10: 323-330.
- 8Oliva M, Singh TP, Gauvreau K, VanderPluym CJ, Bastardi HJ, Almond CS. Impact of medication non-adherence on survival after pediatric heart transplantation in the USA. J Heart Lung Transplant. 2013; 32: 881-888.
- 9Pai AL, McGrady M. Systematic review and meta-analysis of psychological interventions to promote treatment adherence in children, adolescents, and young adults with chronic illness. J Pediatr Psychol. 2014; 39: 918-931.
- 10Miloh T, Annunziato R, Arnon R, et al. Improved adherence and outcomes for pediatric liver transplant recipients by using text messaging. Pediatrics. 2009; 124: e844-e850.
- 11Shellmer DA, Dabbs AD, Dew M, Mazariegos G. Teen pocket PATH: a randomized pilot of a mobile health application to improve adherence among adolescent solid organ transplant recipients. J Heart Lung Transpl. 2014; 33: S32.
- 12Shemesh E, Annunziato RA, Shneider BL, et al. Improving adherence to medications in pediatric liver transplant recipients. Pediatr Transplant. 2008; 12: 316-323.
- 13Belzer ME, Naar-King S, Olson J, et al. Adolescent Medicine Trials Network for HIV/AIDS Interventions. The use of cell phone support for non-adherent HIV-infected youth and young adults: an initial randomized and controlled intervention trial. AIDS Behav. 2014; 18: 686-696.
- 14Belzer ME, Kolmodin MacDonell K, Clark LF, et al. Adolescent Medicine Trials Network for HIV/AIDS Interventions. Acceptability and feasibility of a cell phone support intervention for youth living with HIV with nonadherence to antiretroviral therapy. AIDS Patient Care STDS. 2015; 29: 338-345.
- 15Simons LE, Blount RL. Identifying barriers to medication adherence in adolescent transplant recipients. J Pediatr Psychol. 2007; 32: 831-844.
- 16Dew MA, Dabbs AD, Myaskovsky L, et al. Meta-analysis of medical regimen adherence outcomes in pediatric solid organ transplantation. Transplantation. 2009; 88: 736.
- 17Viner RM, Ozer EM, Denny S, et al. Adolescence and the social determinants of health. Lancet. 2012; 379: 1641-1652.
- 18Sayegh CS, MacDonell KK, Olson-Kennedy J. The impact of cell phone support on psychosocial outcomes for youth living with HIV nonadherent to antiretroviral therapy. AIDS Behav. 2018 Accepted for Publication.
- 19Fredericks EM, Dore-Stites D. Adherence to immunosuppressants: how can it be improved in adolescent organ transplant recipients? Curr Opin Organ Transplant. 2010; 15: 614-620.
- 20Lieber SR, Helcer J, Shemesh E. Monitoring drug adherence. Transplant Rev (Orlando). 2015; 29: 73-77.
- 21Walsh JC, Dalton M, Gazzard BG. Adherence to combination antiretroviral therapy assessed by anonymous patient self-report. AIDS. 1998; 12: 2361-2363.
- 22Christina S, Annunziato RA, Schiano TD, et al. Medication level variability index predicts rejection, possibly due to nonadherence, in adult liver transplant recipients. Liver Transpl. 2014; 20: 1168-1177.
- 23Chisholm MA, Lance CE, Williamson GM, Mulloy LL. Development and validation of an immunosuppressant therapy adherence barrier instrument. Nephrol Dial Transplant. 2005; 20: 181-188.
- 24Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991; 32: 705-714.
- 25Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1: 385-401.
- 26Kolbe LJ, Kann L, Collins JL. Overview of the youth risk behavior surveillance system. Public Health Rep. 1993; 108: 2-10.
- 27Morris SB, DeShon RP. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychol Methods. 2002; 7: 105-125.
- 28Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. New York, NY: Lawrence Erlbaum Associates; 1988: 400.
- 29Pinsky BW, Takemoto SK, Lentine KL, Burroughs TE, Schnitzler MA, Salvalaggio PR. Transplant outcomes and economic costs associated with patient noncompliance to immunosuppression. Am J Transplant. 2009; 9: 2597-2606.
- 30Prihodova L, Nagyova I, Rosenberger J, et al. Adherence in patients in the first year after kidney transplantation and its impact on graft loss and mortality: a cross-sectional and prospective study. J Adv Nurs. 2014; 70: 2871-2883.
- 31Foster BJ, Dahhou M, Zhang X, Dharnidharka VR, Conway J, Ng VL. High risk of liver allograft failure during late adolescence and young adulthood. Transplantation. 2016; 100: 577-584.
- 32Dharnidharka VR, Lamb KE, Zheng J, Schechtman KB, Meier-Kriesche HU. Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: a US national registry analysis. Pediatr Transplant. 2015; 19: 471-476.
- 33Vervloet M, Linn AJ, van Weert JC, De Bakker DH, Bouvy ML, Van Dijk L. The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. 2012; 19: 696-704.
- 34Miech RA, Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975-2015: Volume I, Secondary school students. Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2016; 1-636.
- 35Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE, Miech RA. Monitoring the Future National Survey Results on Drug Use, 1975-2015: Volume II, college students and adults ages 19-55. Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2016; 1-427.
- 36Ellis DA, Naar-King S, Chen X, Moltz K, Cunningham PB, Idalski-Carcone A. Multisystemic therapy compared to telephone support for youth with poorly controlled diabetes: findings from a randomized controlled trial. Ann Behav Med. 2012; 44: 207-215.
Citing Literature
