Effect of eHealth Interventions on Medication Adherence in Kidney Transplant Recipients: Meta-Analysis of Randomised Controlled Trials

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2025-04-08 DOI:10.1111/jorc.70015

Metin Tuncer, Gülsüm Zekiye Tuncer

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引用次数: 0

Abstract

Background

Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients.

Aim

This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients.

Methods

This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024.

Results

The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06–1.35; p = 0.01. Heterogeneity: Q = 8.69; p = 0.28; I² = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05–0.29; p = 0.02. Heterogeneity: Q = 0.45; p = 0.93; I² = 0%) significantly increased in the eHealth intervention group compared with the control group.

Conclusion

The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.

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背景肾移植受者必须终身服用免疫抑制剂，而不坚持服药是导致移植物丢失和死亡的主要风险因素。随着技术的进步，电子健康应用程序被广泛应用于慢性病管理，为改善肾移植受者的服药依从性提供了可能。目的本荟萃分析旨在评估随机对照试验（RCT），这些试验评估了电子健康干预措施在改善肾移植受者服药依从性方面的效果。方法本研究设计为系统综述和荟萃分析，在计划和报告阶段遵循了 PRISMA（系统综述和荟萃分析首选报告项目）协议。电子数据库和人工文献检索是两个主要的数据来源。我们系统地检索了 PubMed、Medline、Web of Science 和 Scopus 数据库中的 RCT 全文。搜索范围包括 2014 年至 2024 年 3 月的研究。结果检索到 524 篇文章。其中有 8 项研究纳入了分析，共有 779 人参与。荟萃分析结果表明，与对照组相比，治疗依从率（RR：1.19；95% CI：1.06-1.35；P = 0.01。异质性：Q=8.69；P=0.28；I2=19%）和依从性评分（SMD：0.17；95% CI：0.05-0.29；P=0.02。异质性：Q = 0.45; p = 0.93; I2 = 0%），与对照组相比，电子健康干预组明显增加。结论本报告的研究结果表明，与标准护理相比，旨在改善肾移植受者服药依从性的电子健康干预措施显示出良好的效果。我们建议采取电子健康干预措施，以提高肾移植受者的长期生存率和患者疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.