title: Nonadherence to immunosuppressive therapy in kidney transplant recipients: can technology help?
abstract: End-stage kidney disease is a life-threatening condition that compels patients to accept either dialysis or transplant. Kidney transplantation is the best choice for patients with end-stage kidney disease because it ensures higher quality of life and longer survival rates than other choices, with less cost for the healthcare system. However, in order for renal recipients to maintain the functioning graft they must take lifelong immunosuppressive medications, with possible side effects and low medication adherence. It is known that low medication adherence in kidney transplant recipients may cause poor outcomes, chronic graft rejection, and graft failure. In this review, the authors give an overview of nonadherence in the transplant setting. In addition, they analyze the role of different technologies as an aid to improve adherence, with a focus on mobile-phone based solutions to monitor and enhance kidney transplant recipient compliance.
authors.affiliation: FBCommunication, Modena, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Nerini
authors.affiliation: FBCommunication, Modena, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bruno
authors.affiliation: Transplantation Unit, Department of Surgery, Università Cattolica, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Citterio
authors.affiliation: Regional Centre of Organ Transplantation, University of Bari, Policlinico, Piazza G. Cesare 11, 70124, Bari, Italy. paolo.schena@uniba.it.
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Schena
mesh_terms: D040421:Cell Phone; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality / Q000523:psychology*; D055118:Medication Adherence; D063731:Mobile Applications; D010353:Patient Education as Topic; D017010:Reminder Systems; D012307:Risk Factors; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D066027:Transplant Recipients / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: Immunosuppressive therapy; Interactive voice response system; Kidney transplantation; Nonadherence