Health Behavior Clinical Trial
Official title:
Mobile Video Directly Observed Therapy (DOT) for Immunosuppression Medication Adherence in Adolescent Heart Transplant Recipients: Enhancing Technological Innovation and Strengthening the Role of Small Businesses in Meeting Needs of Adolescent Organ Transplant
We will conduct a two-group randomized controlled trial to examine the eMocha DOT intervention with pediatric HT recipients.In this population, medication nonadherence remains a primary cause of late acute rejection (LAR) episodes, increased number of hospitalizations, graft failure, and patient mortality. Herein, we propose an innovative approach to promote medication adherence and improve patient and graft outcomes.
Status | Not yet recruiting |
Enrollment | 100 |
Est. completion date | December 31, 2026 |
Est. primary completion date | March 31, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 10 Years to 21 Years |
Eligibility | Inclusion Criteria: - Eligible participants are 10-21 years of age - Have received a heart transplant and are followed participating pediatric heart transplant centers - English-speaking or Spanish-speaking - Own a smart-phone or have access to the mobile app through other devices - Are willing to receive information through it - Have a MLVI score of greater than 2.0 over the last year Exclusion Criteria: • Those with cognitive impairments will not be eligible for enrollment due to inability to provide informed assent |
Country | Name | City | State |
---|---|---|---|
United States | University of Miami, Miller School of Medicine | Coral Gables | Florida |
United States | University of Florida | Gainesville | Florida |
United States | Joe DiMaggio Children's Hospital | Hollywood | Florida |
United States | FSU College of Medicine | Tallahassee | Florida |
Lead Sponsor | Collaborator |
---|---|
University of Florida | emocha Mobile Health, Inc., National Heart, Lung, and Blood Institute (NHLBI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Medication adherence based on medication level variability index | medication level variability index (MLVI). MLVI is calculated as the Standard Deviation of a set of at least 3 tacrolimus trough blood levels for each participant. | 12 weeks | |
Primary | Directly observed medication adherence | Number of doses observed and reviewed by nursing staff compare to number of prescribed doses per day | 1 weeks | |
Primary | Late Acute Rejection | Number of biopsy-proven rejection, clinician-assigned rejection | 6 months post-intervention | |
Primary | Hospitalization | Number of hospitalizations | 6 months post-intervention | |
Primary | Patient Activation Measure | A 13-item scale designed to measure a patient's perception of their knowledge, skill and confidence in managing their chronic health condition | Pretest at enrollment and posttest at 12 weeks | |
Primary | Patient Assessment of Chronic Illness Care (PACIC) | A 20-item scale with five subscales (scale of 1 (none) to 5 (always), total score 20 to 200, higher score being better outcome) that assess patient activation, delivery system design, goal setting, problem-solving and contextual counseling, and follow-up and coordination. | Pretest at enrollment and posttest at 12 weeks | |
Primary | Self-reported user satisfaction with the DOT app | Collected using a modified version of the engagement index questionnaire used | Pretest at enrollment and posttest at 12 weeks | |
Primary | Engagement metrics | Standard engagement metrics or paradata (e.g., amount, frequency, duration, and depth of use) | Pretest at enrollment and posttest at 12 weeks | |
Primary | PedsQL 3.0 Transplant Module (PedsQL-TM) | HRQOL | Pretest at enrollment and posttest at 12 weeks | |
Primary | Adolescent Medication Barriers Scale (AMBS) | To assess adolescent perceived barriers to medication adherence | Pretest, posttest | |
Primary | Parent Medication Barriers Scale (PMBS) | To assess parental perceived barriers to their child taking their medication | Pretest at enrollment and posttest at 12 weeks |
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