Why do Patients Forget to Take Immunosuppression Medications and Miss Appointments: Can a Mobile Phone App Help?

Abstract

BackgroundKidney transplant recipients must adhere to their immunosuppressive medication regimen. However, non-adherence remains a major problem.ObjectiveThe aim of this paper is to determine how kidney transplant recipients remember to take their medications, and assess their perception and beliefs about adherence to immunosuppressive medications and barriers to medication adherence. In addition, we aim to assess perception and beliefs about willingness to use a hypothetical, mobile phone app to improve adherence.MethodsWe conducted a qualitative study that included an average of three home or workplace visits of kidney transplant recipients (N=16) from a single urban transplant center.ResultsThe qualitative study revealed that transplant recipients understood the importance of taking their immunosuppressive medications and this motivated them to take their medications. The visits showed that most participants have incorporated medication use into their daily lives and that any minor deviation from daily routines could result in non-adherence. Participants also reported other barriers to adherence. All participants were interested in using an app to remind them to take their medication; however, they reported potential barriers to using the app.ConclusionsAlthough kidney transplant recipients understood the importance of medication adherence, there were significant barriers to maintaining adherence. Participants also reported interest in using a mobile phone app.

Shedding light on an unknown reality in solid organ transplant patients’ self‐management: A contextual inquiry study

“…[5][6][7][8][9][10] Furthermore, existing studies mostly used quantitative designs, presenting patients with questionnaires consisting of a predetermined list of possible nonadherence reasons or lifestyle problems. [5][6][7][8][9][10] Furthermore, existing studies mostly used quantitative designs, presenting patients with questionnaires consisting of a predetermined list of possible nonadherence reasons or lifestyle problems.…”

“…[5][6][7][8][9][10] Furthermore, existing studies mostly used quantitative designs, presenting patients with questionnaires consisting of a predetermined list of possible nonadherence reasons or lifestyle problems. [7][8][9]14,15 Yet, such studies do not provide insight on how these health behaviors are actually performed by patients on a day-to-day basis, which in part might explain why many adherence interventions tested thus far were not effective. Qualitative studies using focus groups or semistructured interviews can provide a more in-depth understanding of difficulties experienced.…”

“…insufficient physical activity or poor diet received far less attention thus far. [5][6][7][8][9][10] Furthermore, existing studies mostly used quantitative designs, presenting patients with questionnaires consisting of a predetermined list of possible nonadherence reasons or lifestyle problems. 5,6,[11][12][13] This approach rarely allows participants to add other difficulties they experience nor share strategies they might use to manage these risk factors.…”

The Impact of Mobile Application Support on the Quality of Care of Kidney Patients

“…As per the results, the patients showed a positive attitude and behavior towards mobile healthcare applications (Skelton et al, 2015). Israni et al (2016) have investigated whether the use of mobile application enhances the patient adherence rate or not. The qualitative research technique was adopted, and the patients receiving kidney transplant services were included.…”

Racial, Ethnic, and Socioeconomic Disparities in Web-Based Patient Portal Usage Among Kidney and Liver Transplant Recipients: Cross-Sectional Study (Preprint)

“…Studies have indicated that due to the high prescription burden, transplant recipients are interested in web-based applications to assist in their complex medication management. 16 For example, Browning et al reported that 78% of adult kidney recipients had a positive attitude toward the use of mobile health smartphone applications for medication management. 17 Despite previous research showing positive patient attitudes toward health technology, the use of such technology may not be adopted equitably by all patients as minority race, lower educational level, and older age are associated with decreased access to and use of patient portals in other contexts.…”