Adherence Enhancement for Renal Transplant Patients

Despite significant advances in the care of kidney transplant recipients, long term graft survival after renal transplantation remains suboptimal. Medication nonadherence and clinical inertia are key contributors to graft loss. The purpose of the proposed RCT feasibility study is to evaluate impact of a "bundled" wireless real time medication reminder system and blood pressure monitoring system in combination with a cognitive behavioral adherence skills enhancement program upon medication adherence, therapeutic drug concentration, and blood pressure, in nonadherent kidney transplant recipients with hypertension. We propose to recruit 60 kidney transplant recipients in phase 1 with 20 non-adherent continuing to phase 2 for a 5-month feasibility RCT.

subjects provided with electronic medication tray, electronic blood pressure cuff, and a smart phone.

mHealth prototype system consisting of electronic medication tray, blood pressure cuff and smart phone

Inclusion Criteria: Persons > 21 years of age first time recipient of a solitary kidney transplant prescribed at least 3 medications for immunosuppression and hypertension previous history of non-adherence functioning kidney transplant ability to speak, hear and understand English able to use medication delivery device and self administer medications able to operate blood pressure monitor comfortable using cell phone no other diagnosis that might shorten lifespan transplant physician's assent that the patient can participate Exclusion Criteria: failure to meet all inclusion criteria

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