Patient Education After Lung Transplantation Via Tablet Computers Versus Conventional Education
Patient Education After Lung Transplantation Via Tablet Computers Versus Conventional Education - a Randomized Open Controlled Trial
Experimental intervention:
Patient education after lung transplantation via Tablet computers. An electronic patient questionnaire via tablet computer will be collected in addition.
Control intervention:
Conventional Patient education by health care professionals. A paper-based patient questionnaire will be provided.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Noncompliance with immunosuppressive medications after organ transplantation is thought to be a leading cause of allograft rejection, graft loss, and death. Immunosuppressant medy to prevent graft rejection after lung transplantation.
Reported non-compliance rates with calcineurin inhibitors are ranging between 13 and 22 % after lung transplantation. Incidence of non-compliance increases over time after transplantation. Increased health care costs, decreased quality of life, and organ failure (incl. the need for re-do transplantation) are possible consequences of immunosuppressant noncompliance. Therefore, medication compliance defined as the extent to which a patient's medication taking behaviour coincides with the prescribed regimen, is a critical issue in transplantation. Repeated patient education is one option to overcome non-adherence and immunosuppressive medication non-compliance.
Immunosuppressive therapy is monitored by measurement of drug levels. Fluctuating drug levels increase the risk for rejection and drug toxicities. In addition, frequent dose adjustments, case management and frequent monitoring of drug levels are cost-intensive.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Lower Saxony
-
Hanover, Lower Saxony, Germany, 30625
- Hanover Medical School
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients at least 6 months after lung transplantation (single, double or combined)
- Informed consent
- At least 10 trough levels analyzed in MHH reference lab in last 6 months
- < 50% of calcineurin inhibitor trough levels in target range in last 6 months in outpatient clinic
Exclusion Criteria:
- Hospitalization during last 3 months
- BOS stage 3 (FEV1 < 50% baseline)
- End stage kidney disease (GFR <15 ml/min/1.73 m2 or renal replacement therapy)
- Oxygen requirement at rest
- Steroid pulse therapy (>500 mg methylprednisolone per day) during the last 4 weeks
- Illiteracy
- Need for isolation (Colonization with multi. or pan resistant organisms, e.g. MRSA, B. cenocepacia)
- limited German language skills or other reasons which might impair patient communication or computer handling
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Conventional Patient education
Conventional Patient education by health care professionals.
|
Patient education by health care professional compared to education via tablet PC
|
|
Experimental: Patient education via Tablet computer
Patient education after lung transplantation via Tablet computers.
An electronic patient questionnaire via tablet computer will be collected in addition.
|
Patient education by health care professional compared to education via tablet PC
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Calcineurin trough levels
Time Frame: 6 month
|
Improvement of percentage of calcineurin inhibitor trough levels (Delta %) in target range 6 months after patient education compared to 6 months before patient education
|
6 month
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Calcineurin trough levels variability
Time Frame: 6 month
|
Trough level variability 6 months after patient education compared to 6 months before patient education
|
6 month
|
|
Interval Adherence
Time Frame: 6 month
|
interval adherence (number of measurements vs. recommended measurements) 6 months after patient education compared to 6 months before patient education
|
6 month
|
|
Trough level interval
Time Frame: 6 month
|
Interval of trough level measurement variability 6 months after patient education compared to 6 months before patient education
|
6 month
|
|
Total time of education
Time Frame: 6 month
|
Total time of education
|
6 month
|
|
Total time of answering questionnaire
Time Frame: 6 month
|
Total time of answering questionnaire
|
6 month
|
|
Knowledge Improvement
Time Frame: 6 month
|
Improvement of patient knowledge on immunosuppressive after patient education
|
6 month
|
|
Self rated adherence
Time Frame: 6 month
|
Self rated adherence to immunosuppressive medication (BAASIS scale)
|
6 month
|
|
Adherence
Time Frame: 6 month
|
Therapy adherence 6 months after patient education compared to 6 months before patient education
|
6 month
|
|
Glomerular filtration rate
Time Frame: 6 month
|
Glomerular filtration rate 6 months after patient education compared to baseline (CKD-EPI)
|
6 month
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jens T Gottlieb, MD, Hannover Medical School
Publications and helpful links
General Publications
- Mellon L, Doyle F, Hickey A, Ward KD, de Freitas DG, McCormick PA, O'Connell O, Conlon P. Interventions for increasing immunosuppressant medication adherence in solid organ transplant recipients. Cochrane Database Syst Rev. 2022 Sep 12;9(9):CD012854. doi: 10.1002/14651858.CD012854.pub2.
- Suhling H, Rademacher J, Zinowsky I, Fuge J, Greer M, Warnecke G, Smits JM, Bertram A, Haverich A, Welte T, Gottlieb J. Conventional vs. tablet computer-based patient education following lung transplantation--a randomized controlled trial. PLoS One. 2014 Mar 7;9(6):e90828. doi: 10.1371/journal.pone.0090828. eCollection 2014.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- V 2.0 16/03/2011
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