A mixed-method systematic review examining the effects of digital behaviour change interventions (DBCIs) focussing on improving medication adherence in adolescent and young adult kidney transplant patients
Akanksha Singh1, Kim Dr. Bul1, Andy Prof Turner1, Nithya Dr. Krishnan2, Stephen Prof Marks3,4.
1Centre of Intelligent Healthcare, Coventry University, Coventry, United Kingdom; 2Kidney transplant, University Hospitals Coventry & Warwickshire, Coventry, United Kingdom; 3Pediatric Nephrology, Great Ormond Street Hospital for Children, London, United Kingdom; 4University College London, London, United Kingdom
Introduction: Non-adherence to immunosuppressants is one of the leading causes of premature transplant failure among adolescent and young adult kidney transplant recipients. An increasing number of studies have shown the effectiveness of DBCIs to promote treatment adherence in kidney transplant patients. The aim of this systematic review is to evaluate the effects of digital behaviour change interventions in young kidney transplant patients.
Methods: Searches were conducted through MEDLINE, PsycINFO, PubMed, CINAHL, Embase, Scopus, Google Scholar, and Web of Science to identify digital behaviour change interventions designed specifically for young kidney transplant patients. Potential studies were screened and selected independently by two researchers. Data were extracted and the risk of bias was assessed by one reviewer and validated by a second reviewer. The PRISMS taxonomy is used to describe the DBCIs.
Results: Initial searches resulted in a total of 901 studies with a final selection of 10 studies (8 quantitative, 2 qualitative). The overall quality of the studies was considered as moderate. 3 out of 10 studies included in this review comprised multi-component interventions to improve treatment adherence. Skills training, in conjunction with other forms of interventions, particularly phone counselling, was commonly employed and generally effective in improving self-management outcomes. The results of this review showed a positive correlation between the digital intervention and improved knowledge, social support and favourable clinical outcomes.
Discussion: Digital interventions such as mobile health applications, computer systems and multi-component interventions have the potential to improve treatment adherence in adolescents and young adult kidney transplant recipients. DBCIs can be used as a feasible tool for providing long-term, tailor-made interventions for young kidney transplant patients to improve the goals assessed.
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