移动医疗系统对美国活体肾供者2年随访依从性的有效性

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-03-27 DOI:10.1111/ctr.70139

Alvin G. Thomas, Sarah Hussain, Samantha B. Klitenic, Carolyn N. Sidoti, Madeleine M. Waldram, Amy Chang, Jennifer D. Motter, Kelly Terlizzi, Allan B. Massie, Mary Schofield, Karol Barstow, Adam Bingaman, Dorry L. Segev, Macey L. Levan

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引用次数: 0

摘要

器官获取和移植网络（OPTN）政策要求对活体肾供者（LKDs）进行2年随访；然而，许多移植医院难以满足这一要求。我们在一项随机对照试验（RCT）中开发并测试了一种用于LKD随访的移动医疗（mHealth）系统。方法将lkd随机分配到干预组（移动健康+标准护理组）或对照组（标准护理组）。我们评估了OPTN政策定义的6个月、1年和2年随访的完整性和及时性。400名LKDs参加了这项研究（2018年6月至2021年2月）。结果在随访6个月时，干预组完成复合就诊的比例较高（97.5% vs. 91.5%, p = 0.01）。在1年和2年随访中，两组患者的依从率相似（92.0%对89.5%,p = 0.49, 66.5%对65.0%,p = 0.83）。干预组参与者比对照组提前11天完成6个月的随访（p = 0.009）。结论：在该单中心RCT中，移动健康技术改善了6个月的随访，但对1年和2年的LKD随访没有影响。其他战略，如提供数据收集以外的服务，可能是改善捐助者参与和支持LDK长期后续行动所必需的。

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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Effectiveness of a Mobile Health System on Compliance With 2-Year Living Kidney Donor Follow-Up in the United States

Background

Organ Procurement and Transplantation Network (OPTN) policy requires 2 years of follow-up for living kidney donors (LKDs); however, many transplant hospitals struggle to meet this requirement. We developed and tested a mobile health (mHealth) system for LKD follow-up in a pilot randomized-controlled trial (RCT).

Methods

LKDs were randomly assigned to either the intervention (mHealth + standard of care) or control arm (standard of care). We assessed OPTN policy-defined completeness and timeliness of 6-month, 1-year, and 2-year follow-ups. Four hundred LKDs were enrolled in the study (June 2018 to February 2021).

Results

At 6-month follow-up, a higher proportion of the intervention arm participants completed composite visits (97.5% vs. 91.5%, p = 0.01). Both arms had similar compliance rates at 1- and 2-year follow-up (92.0% vs. 89.5%, p = 0.49, and 66.5% vs. 65.0%, p = 0.83). Intervention arm participants completed 6-month follow-up 11 days earlier than their counterparts (p = 0.009).

Conclusion

mHealth technologies improved 6-month follow-up, but did not impact 1- and 2-year LKD follow-up in this single-center RCT. Other strategies, such as providing services beyond data collection, may be necessary to improve donor engagement and support LDK's long-term follow-up.

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.