- A telehealth pilot program developed by the University of Kansas Medical Center helped kidney transplant patients reduce weight gain and improve diet and exercise in the crucial months following a transplant, reducing the chances of organ rejection or other serious health outcomes.
The program, in which patients attended weekly online sessions for three months to learn about diet and nutrition and took part in guided physical activity, saw statistically significant increases in activity and fruit and vegetable consumption, researchers reported. Just as important, 90 percent of those enrolled in the program stayed with it through its completion, and all said they would recommend it to other transplant patients.
Now researchers are looking for National Institutes of Health backing to expand the program.
“It really opened our eyes about what works in a telemedicine delivery program,” Cheryl Gibson, a professor of internal medicine at KU Medical Center and lead researcher, said in a story published by the University of Kansas. “We think this is a really good fit for kidney transplant patients, and our hope is this kind of technology would be used across all kinds of chronic health conditions.”
Nationwide, there were 19,849 kidney transplants performed in the US in 2017, and the University of Kansas Health System Center for Transplants performed about 130 of them.
Gibson and her colleagues developed the program to target post-transplant weight gain in kidney transplant patients. For these patients, weight gain is a common – and potentially life-threatening – side-effect of the surgery.
“Obesity after transplantation puts patients at a higher risk of cardiovascular disease and graft failure, among other problems,” Gibson said “If they are placed on the transplant waiting list for re-transplantation, the chances of them getting another kidney are often low due to obesity. In addition, a repeat transplant puts patients at a higher risk of rejection.”
Working with Dr. Aditi Gupta, a transplant nephrologist; Rebecca Mount, a registered dietitian, and Leon Greene, an associate professor of health, sport and exercise science, Gibson created a connected health platform whereby Mount would teach patients about nutrition and diet, as well goal setting, self-monitoring, portion control, meal planning and shopping, cooking skills and how to eat healthy away from home. Greene then led 30-minute physical activity sessions designed to get the patients moving around the house more and more each day.
Gibson said she and her colleagues found value in the telehealth program beyond weight gain prevention. Virtual care platforms, she said, enable patients to take part in education and exercise programs at home, without having to travel to and from a gym or health center or sign up for a health program.
They also have social value.
“We were very happy the participants liked the program,” Gibson said. “They reported feeling isolated during dialysis and recovery and loved being able to talk to people in the same situation they were in and said they wanted to participate in the program longer.”
KU joins an increasing number of health systems using telehealth and telemedicine platforms to connect with patients pre- and post-transplant for better care coordination and management.
Just this year, both the University of Alabama at Birmingham (UAB) School of Medicine and Vanderbilt University Transplant Center have created or expanded telemedicine programs for transplant patients.
“Being able to see the patients via telehealth not only saves them time, but also reduces the stress of having to make plans to travel for their annual appointments,” Clifton Kew, MD, medical director of the Kidney and Pancreas Transplant Program in Birmingham, said in a news release issued by UAB. “II hope this will make it easier for patients to keep their appointments so we can make sure their health is continuing to improve.”
The KU program also illustrates the growth of telehealth and telemedicine programs for post-operative rehabilitation, for everything from simple surgeries to joint replacements. And the nutrition education element follows the growth of online programs for health and wellness, particularly for people with chronic conditions.