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Digital Reminders May Help Transplant Patients Remember Their Medications

A South Carolina university is using a $1 million NIH grant to determine if an mHealth platform can improve compliance among kidney transplant patients - and perhaps save their lives.

- Researchers at the Medical University of South Carolina are using a $1 million grant to determine if digital medication reminders can save lives.

The lives in question are those of kidney transplant patients, who take, on average, 15 different medications a day. Long-term survival rates are low, in many cases due to failure to keep up with those medications (including remembering when and in which order to take the medications) and the onset of premature graft loss.

Fueled by a $1.11 million grant from the National Institutes of Health, researchers from the MUSC College of Medicine’s Department of Surgery and the College of Nursing will study whether individual medication reminders delivered on an mHealth platform can improve compliance, reduce setbacks and a need for dialysis and, ultimately, improve clinical outcomes.

"We know it's asking a lot to expect the patient to stay on track with their medications," John McGillicuddy, MD, who’s leading the study, told News-Medical.net. "Unfortunately, we also know medication non-adherence and the resulting uncontrolled hypertension are predominant risk factors for premature graft rejection, graft loss and death. With this study, we're looking at ways to keep patients on schedule with a computer automated monitoring system using mobile technology to improve patient outcomes."

McGillicuddy, an associate professor of surgery at MUSC’s Division of Transplant Surgery and the study’s lead investigator, said a much smaller study had shown that mHealth technology could improve both medication adherence and blood pressure levels, but it was too small to measure effects on the kidney graft. The NIH grant will allow them to expand the study.

In 2011, physicians and IT experts at the University of Iowa Children’s Hospital launched a Facebook app targeted at young transplant recipients. The Iowa MedMinder app was customized for each patient and designed to remind the young Facebook surfer (via a pop-up box) about medications that need to be taken each day.

"Teenagers and young adults do pretty well when it comes to taking their medications initially after a transplant, but the largest number of kidney failures in this age group comes from noncompliance,"  Patrick Brophy, MD, director of the Division of Pediatric Nephrology, Dialysis and Transplantation at UI Children's Hospital, said in a 2011 interview. "They get to feeling better, they start hanging out with their friends and they stop taking their medications. It's too bad, they're at the time of their lives when they should be out having fun with their friends and instead we're losing a lot of kidneys."

Roughly one year ago, Phoenix, Ariz.-based Avelia Specialty Pharmacy reported that a mobile app designed to help HIV patients remember to take their medications each day increased medication adherence threefold.

With an estimated one-third of all Americans admitting that they don’t take their medications when they should – costing the nation, as of 2014, some $290 billion in healthcare costs and causing 125,00 deaths annually - health systems and pharmacies are trying everything from text messages and smartphone alerts to gamification to smart pill bottles to improve not only compliance, but adherence.

More recently, they’ve been experimenting with medication reminders via wearables (including the Apple watch) and even “smart pills” that are ingested and deliver dosed medications at specific times.

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