title: Development and field testing of Teen Pocket PATH(®), a mobile health application to improve medication adherence in adolescent solid organ recipients.
abstract: Applying principles of user-centered design, we iteratively developed and tested the prototype of TPP, an mHealth application to promote medication adherence and enhance communication about medication management between adolescents and primary caregivers. A purposive sample of seven adolescent solid organ transplant recipients who were ≥ one yr post-transplant and their primary caregivers participated. Participants completed up to three face-to-face laboratory usability sessions, a 6-week field test, and a debriefing session. Primary caregivers participated in an additional usability telephone session. Participants completed usability and satisfaction measures. Sample included liver (n = 4), heart (n = 2), and lung (n = 1) recipients aged 11-18 yr (57% were female, 86% were Caucasian), and nine primary caregivers aged 42-61 yr (88.9% were parents, 88% were female, 88% were Caucasian). Ninety percent of the adolescents endorsed the graphs or logs of missed/late medication dosing as useful and 100% endorsed the remaining features (e.g., medication list, dose time reminders/warnings) as useful. All adolescents expressed interest in using TPP for monitoring medications and satisfaction with the automatic messaging between adolescent and caregiver versions of the application. Adolescents unanimously found TPP easy to use. TPP shows promise as an mHealth adherence tool.
authors.affiliation: Department of Pediatric Transplant Surgery, School of Medicine University of Pittsburgh, Pittsburgh, PA, USA.|Hillman Center for Pediatric Transplantation, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Shellmer
authors.affiliation: Departments of Psychiatry, Psychology, Epidemiology and Biostatistics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.affiliation: Department of Pediatric Transplant Surgery, School of Medicine University of Pittsburgh, Pittsburgh, PA, USA.|Hillman Center for Pediatric Transplantation, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Mazariegos
authors.affiliation: Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: DeVito Dabbs
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine / Q000379:methods; D000328:Adult; D017028:Caregivers; D002648:Child; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016377:Organ Transplantation; D017060:Patient Satisfaction; D017010:Reminder Systems; D012648:Self Care; D011795:Surveys and Questionnaires; D017216:Telemedicine; D060145:Text Messaging; D066027:Transplant Recipients; D016896:Treatment Outcome; D014584:User-Computer Interface
chemical_list: D007166:Immunosuppressive Agents
keywords: adherence; heart transplantation; liver transplantation; lung transplantation; medication management; mobile health; pediatric transplantation