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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT05732779
Other study ID # IRB202201809
Secondary ID R44HL167591-01A1
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date March 31, 2024
Est. completion date December 31, 2026

Study information

Verified date March 2024
Source University of Florida
Contact Dipankar Gupta, MD
Phone 352-273-5422
Email dgupta@ufl.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

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.


Description:

Few interventions have proven to be successful in promoting medication adherence and impacting short- and long-term post-transplant outcomes in adolescent heart transplant (HT) recipients. Improving adherence is a persistent challenge with youth experiencing chronic health conditions, especially among adolescent transplant recipients. Adolescent organ transplant recipients experience unique challenges remaining adherent to the complex post-transplant regimen, with rates of non-adherence as high as 40% to 60%. In this population, medication non-adherence 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.


Recruitment information / eligibility

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

Study Design


Intervention

Other:
DOT intervention
A mobile health application developed by eMocha Health Inc. facilitates asynchronous mobile video directly observed therapy (DOT) intervention, empowering users to track dose-by-dose medication adherence

Locations

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

Sponsors (3)

Lead Sponsor Collaborator
University of Florida emocha Mobile Health, Inc., National Heart, Lung, and Blood Institute (NHLBI)

Country where clinical trial is conducted

United States, 

Outcome

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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