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Table 6 Studies evaluating technology-based adherence-promoting interventions among kidney transplant recipients

From: ICT-based adherence monitoring in kidney transplant recipients: a randomized controlled trial

Authors, Year [Ref.] Study design and sample Intervention Duration Adherence Results for adherence and clinical outcomes Advantage Disadvantages
Henriksson et al., 2016 [9] RCT
n = 80 (40 intervention, 40 control)
Device: Electronic medication dispenser
Feedback: emitted visual and audible alerts
12 months Dose-taking adherence No significant differences in tacrolimus trough levels, risk of BPAR, or creatinine levels   No adherence information in the control group
Measured only dispenser opening, not actual pill ingestion
Reese et al., 2017 [8] RCT
n = 117 (40 reminders, 39 reminders plus provider notification, 38 control)
Device: Electronic medication monitor and reminders either alone or in combination with provider notification
Feedback: alarms, texts, telephone calls, and/or e-mails
6 months Dose-taking adherence Significantly better adherence with reminders plus provider notification and with reminders alone compared to in the control group
No significant difference in tacrolimus trough levels
Various feedback methods Measured only dispenser opening, not actual pill ingestion
Foster et al., 2018 [7] RCT
N = 169 (81 intervention, 88 control)
Device: Electronic medication monitor and face-to-face education
Feedback: text messages, e-mails, and/or visual cue dose reminders
12 months Dose-taking adherence and dose-frequency adherence Intervention group had significantly better adherence than the control group
No significant difference in the standard deviation of tacrolimus trough levels
Various feedback methods Measured only dispenser opening, not actual pill ingestion
Jung et al., 2020 [the current study] RCT
N = 105 (51 intervention, 54 control)
Device: Smart pill box
Feedback: text messages, pill box alarms
6 months Dose-taking adherence, dose-frequency adherence, and dose-interval adherence No significant difference in adherence, tacrolimus and mycophenolic acid trough levels, coefficient of variation of drug levels, and risk of the development of de novo anti-HLA antibodies The ICT-based centralized monitoring system can be linked to not only smart pill box but also blood sugar meter, electrocardiogram, spirometry, and INR meter Measured only box opening, not actual pill ingestion
  1. HLA Human leukocyte antigen, ICT Information and communication technology, RCT Randomized controlled trial