A new intervention to increase medication adherence in kidney transplant recipients: investigation of effect of SystemCHANGE intervention
Yaprak Sarıgöl Ordin1, Serkan Yıldız3, Eda Ayten Kankaya1, Buket Çelik1, Nermin Ertan5, Özgül Karayurt2, Cynthia L. Russell4.
1Nursing Faculty, Dokuz Eylul University , Izmir, Turkey; 2Faculty of Health Science Department of Nursing, Izmir University of Economics, Izmir, Turkey; 3Nephrology Department , Medicana Hospital. , Izmir, Turkey; 4University of Missouri-Kansas City, Kansas City, MO, United States; 5Nephrology Department , Dokuz Eylul University , Izmir, Turkey
Introduction: In all organ transplant recipients, immunosuppressive drugs are important in terms of the prevention of rejection, transplanted organ and patient survival. Non-adherence with immunosuppressive drugs is an important problem affecting patient outcomes in kidney transplant recipients. Medication adherence intervention studies are not theory based, intervention effect sizes are low, and studies lack methodologic rigor. The primary aim of the study is to evaluate the effect of the SystemCHANGE™ invervention applied in kidney transplant recipients on medication adherence. The secondary aim is to examine the effects of the SystemCHANGE™ intervention applied in kidney transplant recipients on the health outcomes (infection, rejection, graft loss, death, blood urea nitrogen and creatinine level) and quality of life.
Method: The study used a randomized controlled single-blind study design. Electronic medication monitoring was used for three months to screen for medication nonadherence. Medication adherence was meassured by the Medication Event Monitoring System SmartCap® (MEMSCap™). Participants with a high level of medication adherence (>.85) were excluded from the study while those with medication nonadherence (</= .85) were randomized into the study. The intervention group received the 6-month SystemCHANGE™ intervention and the attention control group received the 6-month patient education intervention. The follow-up phase continues six months after the intervention when no intervention is delivered. Infection, rejection, graft loss, death, blood urea nitrogen and creatinine level of the participants were evaluated. Quality of of life level was evaluated by SF-36.
Results: The 6-month intervention phase of the study has been completed and the 6-month follow-up period is currently being delivered. Results of the study will be presented at the congress.
Conclusion: This study is the second in the international literature to evaulate the effect of a new intervention-SystemCHANGE™, on medication adherence in kidney transplant recipients and the first to evaluate in Turkish kidney transplant recipients.
This research is supported by TUBITAK 1001 - Support Program for Scientific and Technological Research Projects with project number 218S720. We thank TUBITAK for their support.
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