title: Patient attitudes toward mobile phone-based health monitoring: questionnaire study among kidney transplant recipients.
abstract: BACKGROUND
  Mobile phone based remote monitoring of medication adherence and physiological parameters has the potential of improving long-term graft outcomes in the recipients of kidney transplants. This technology is promising as it is relatively inexpensive, can include intuitive software and may offer the ability to conduct close patient monitoring in a non-intrusive manner. This includes the optimal management of comorbidities such as hypertension and diabetes. There is, however, a lack of data assessing the attitudes of renal transplant recipients toward this technology, especially among ethnic minorities.
  
  
  OBJECTIVE
  To assess the attitudes of renal transplant recipients toward mobile phone based remote monitoring and management of their medical regimen; and to identify demographic or clinical characteristics that impact on this attitude.
  
  
  METHODS
  After a 10 minute demonstration of a prototype mobile phone based monitoring system, a 10 item questionnaire regarding attitude toward remote monitoring and the technology was administered to the participants, along with the 10 item Perceived Stress Scale and the 7 item Morisky Medication Adherence Scale.
  
  
  RESULTS
  Between February and April 2012, a total of 99 renal transplant recipients were identified and agreed to participate in the survey. The results of the survey indicate that while 90% (87/97) of respondents own a mobile phone, only 7% (7/98) had any prior knowledge of mobile phone based remote monitoring. Despite this, the majority of respondents, 79% (78/99), reported a positive attitude toward the use of a prototype system if it came at no cost to themselves. Blacks were more likely than whites to own smartphones (43.1%, 28/65 vs 20.6%, 7/34; P=.03) and held a more positive attitude toward free use of the prototype system than whites (4.25±0.88 vs 3.76±1.07; P=.02).
  
  
  CONCLUSIONS
  The data demonstrates that kidney transplant recipients have a positive overall attitude toward mobile phone based health technology (mHealth). Additionally, the data demonstrates that most kidney transplant recipients own and are comfortable using mobile phones and that many of these patients already own and use smart mobile phones. The respondents felt that mHealth offers an opportunity for improved self-efficacy and improved provider driven medical management. Respondents were comfortable with the idea of being monitored using mobile technology and are confident that their privacy can be protected. The small subset of kidney transplant recipients who are less interested in mHealth may be less technologically adept as reflected by their lower mobile phone ownership rates. As a whole, kidney transplant recipients are receptive to the technology and believe in its utility.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA. mcgillij@musc.edu
authors.forename: John William
authors.initials: JW
authors.lastname: McGillicuddy
authors.forename: Ana Katherine
authors.initials: AK
authors.lastname: Weiland
authors.forename: Ronja Maximiliane
authors.initials: RM
authors.lastname: Frenzel
authors.forename: Martina
authors.initials: M
authors.lastname: Mueller
authors.forename: Brenda Marie
authors.initials: BM
authors.lastname: Brunner-Jackson
authors.forename: David James
authors.initials: DJ
authors.lastname: Taber
authors.forename: Prabhakar Kalyanpur
authors.initials: PK
authors.lastname: Baliga
authors.forename: Frank Anton
authors.initials: FA
authors.lastname: Treiber
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D040421:Cell Phone / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D020407:Internet; D016030:Kidney Transplantation / Q000502:physiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000523:psychology; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*