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Pilot Feasibility Clinical Trial: Telemedicine Infused Adherence Enhancement for Renal Transplant Patients. John W McGillicuddy, MD Frank A Treiber, PhD Martina Mueller, PhD Gayenell S Magwood , PhD, RN Gail Johnson, MS

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  1. Pilot Feasibility Clinical Trial: Telemedicine Infused Adherence Enhancement for RenalTransplant Patients John W McGillicuddy, MDFrank A Treiber, PhDMartina Mueller, PhDGayenell S Magwood, PhD, RN Gail Johnson, MS Presented: Verizon Wireless Health Technology Initiative Meeting, Nov. 15, 2011 • Subtitle • Presenters • Date http://sctr.musc.edu 843-792-8300

  2. Rationale • ESRD afflicts more than 500,000 people in the USA • HTN and DM are the #1 and #2 causes of ESRD • Kidney transplantation is the treatment of choice for ESRD • Kidneys are an incredibly scarce resource which mandates that their use be optimized • Despite significant advances, average graft survival is suboptimal at approximately 9 years • Graft survival is worse among African-Americans and those of lower socioeconomic status http://sctr.musc.edu 843-792-8300

  3. Rationale • Medication nonadherence is key contributor to premature graft loss • Approximately 35% of renal transplant patients are nonadherent and issues often develop within weeks of transplantation • Medication nonadherence contributes to graft loss by allowing for immune mediated rejection and the deleterious effects of poorly controlled HTN and DM • Mobile health technology has the potential to improve medication adherence, blood pressure and blood sugar control, and graft survival http://sctr.musc.edu 843-792-8300

  4. Aim • Utilize wireless technology to identify nonadherent patients early after transplant and to interact with them in real time to improve adherent behaviors as a means to improve: • Medication adherence • Control of HTN • Control of DM • Graft survival http://sctr.musc.edu 843-792-8300

  5. Study Design and Methods • Type: Randomized control trial • Subjects: 20 nonadherent kidney transplant patients • Methods: randomly assigned to: • Group A: standard post operative care • Group B: “bundled” wireless real time medication reminder system, blood pressure/blood glucose monitoring, cognitive behavior adherence skills enhancement program http://sctr.musc.edu 843-792-8300

  6. Study Design and Methods • Technology • Maya MedMinder to monitor and aid in medication adherence • Bluetooth enabled Fora D15b to measure and record BP and blood glucose • “Smart” phones for signal transmission • “Smart” phones for patient interaction • Cognitive behavioral enhancement techniques via video conferencing with adherence coach http://sctr.musc.edu 843-792-8300

  7. Study Design and Methods • Outcomes (measured pre-, 1, 2, and 3 months): • Medication adherence (Maya MedMinder) • Blood pressure control (Fora D15b, 24h ambulatory BP) • Blood glucose control (Fora D15b, HgbA1c) • Immunosuppression (FK506 variability) http://sctr.musc.edu 843-792-8300

  8. Approximately $450.00. Power drain from Bluetooth data transfer. Easy to lose.

  9. TENSION TAMER • Content • Content Presented by the COLLEGES of NURSING and MEDICINE http://sctr.musc.edu 843-792-8300

  10. Study Design and Methods http://sctr.musc.edu 843-792-8300

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