The Effect of SystemCHANGE™ on medication adherence in kidney transplant recipients: a randomized clinical trial

Sarıgöl Ordin Y., Çelik B., Kankaya E. A.

ESOT- The European Society for Organ Transplantation Congress 2023, Athens, Yunanistan, 17 - 21 Eylül 2023, cilt.0, sa.0

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 0
  • Basıldığı Şehir: Athens
  • Basıldığı Ülke: Yunanistan
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Background: The SystemCHANGETM intervention harnesses patients’ established daily routines/habits, environment, and important others, as possible solutions that are reoccurring and thus reliable systems that could support medication taking to become a dependable routine/habit. The aim of this study was to evaluate the effect of a six -month SystemCHANGE™ intervention compared to a six-month attention-control education intervention on medication adherence and quality of life in kidney transplant recipients. A six-month maintenance phase where the intervention was withdrawn was also evaluated.

Methods: A randomized controlled trial single-blind (participants) study design was used. After screening for 3 months using electronic monitoring, participants with medication adherence (>.85) were excluded from the study while those with medication nonadherence (</= .85) were randomized. The intervention group received the 6-month SystemCHANGETM intervention (n= 21)  and the attention control group (n= 21) received the 6-month patient education intervention. The maintenance phase continued for six months afterwards. Electronic monitoring was used to measure medication adherence.

Results: At the completion of the six-month intervention phase, there was a statistically significant difference in medication adherence between the SystemCHANGETM (median 0.97, IQR 0.93 -0.98) and attention control (median 0.81, IQR 0.71-0.87) groups (U= 4.190, p< .001). At the completion of the 6-month maintenance phase, the statistically significant difference was maintained between the SystemCHANGETM (median 0.94, IQR 0.81-0.96) and attention control (median 0.76.00, IQR 0.69-0.86) groups (U= 2.843, p< .004, Table 1, Figure 1). There was no difference in the quality of life between groups (p> 0.05).

Conclusion: This study, which had a strong research design, showed that the SystemCHANGE™ intervention was effective in improving patients' medication adherence and outcoes.