No abstract

Purpose: HT recipients experience high levels of medication non-adherence during adolescence.Thispilotstudyexaminedtheacceptabilityandfeasibilityofanasynchro-nousDOTmHealthapplicationamongadolescentHTrecipients.Theappfacilitates trackingofpatients'dose-by-doseadherenceandenablestransplantteammembers toengagepatients.TheDOTapplicationallowspatientstoself-recordvideoswhile takingtheirmedicationandsubmitforreview.Transplantstaffreviewthevideosand communicate with patients to engage and encourage medication adherence. Methods: Ten adolescent HT recipients with poor adherence were enrolled into a single-group, 12-week pilot study examining the impact of DOT on adherence. Secondaryoutcomesincludedself-reportmeasuresfrompatientsandparentsconcerning HRQOL and adherence barriers. Long-term health outcomes assessed in-cludedARandhospitalization6monthsfollowingDOT. Findings: Among14adolescentHTpatientsapproached,10initiatedtheDOTintervention. Of these, 8 completed the 12-week intervention. Patients and caregivers reportedhighperceptionsofacceptabilityandaccessibility.Patientssubmitted90.1% ofpossiblevideosdemonstratingmedicationdosestaken.MLVIvaluesforthe10pa-tientsinitiatingDOTdecreasedfrom6monthspriortotheintervention(2.86± 1.83) to6monthsfollowingtheirinvolvement(2.08±0.87)representinga21.7%decrease innon-adherence,thoughnotstatisticallysignificantgiventhesmallsamplesize. Conclusions: Result of this pilot study provides promising insights regarding the feasibility,acceptability,andpotentialimpactofDOTforadolescentHTrecipients.Further randomizedstudiesarerequiredtoconfirmtheseobservations.

Medication non-adherence causes poor outcomes in paediatric organ transplantation. COVID-19 pandemic has led to an exponential use of mobile health approaches for patient care. Herein, we describe a pilot intervention study using mobile video directly observed therapy building on emerging trends in research and clinical practice pertaining to medication adherence in paediatric organ transplantation.