The Effect of Education on Quality of Life, Adherence to Immunosuppressive Therapy and Symptom Control in Organ Transplant Patients

The Effects of Different Educational Methods Given to Patients Undergoing Organ Transplantation on Quality of Life, Compliance With İmmunosuppressive Therapy and Symptom Control

Organ transplantation is the most effective method for treating end-stage organ failure and allows patients on the verge of death to continue living. Organ transplantation involves removing all or part of an organ or tissue from the body and transplanting it to suitable patients experiencing failure. Therefore, transplants are performed to treat diseases, save lives, improve patients' quality of life, and extend their life expectancy. The World Health Organization (WHO) defines quality of life as individuals' perceptions of their goals, expectations, standards, and concerns regarding their place in life, within the context of the culture and value systems they live in. Achieving an adequate quality of life after transplantation is considered an indicator of therapeutic success, which is increasingly important to measure by the transplant care team.

Individuals who undergo transplantation and their families often perceive transplantation as a rebirth. However, 30% to 40% of patients report no better health-related quality of life after kidney transplantation compared to dialysis. This is attributed to frequent checkups and monitoring, new medications and their strict dosing schedules, and the unexpected discomfort of potential side effects.

Even after the psychological challenges of waiting and the joy of a successful transplant, transplant recipients take on new responsibilities. Problems such as accepting transplantation risks, acute and chronic organ rejection, and adherence to lifelong medication regimens can arise. Persistent side effects of various immunosuppressive agents, adaptation and maintenance of the new organ, and uncertainty about the future due to rejection of transplanted organs and the subsequent re-transplantation process can all lead to physical and psychological distress.

Immunosuppressive therapy represents a lifelong endeavor for transplant recipients. These medication regimens involve complex protocols, not only due to the number of pills required, but also due to blood level monitoring, side effects, and frequent dose adjustments to avoid rejection. Non-adherence to immunosuppressant regimens has been shown to be high in organ transplant patients. Non-adherence rates in this population are reported as high as 65%. The highest immunosuppressant non-adherence rate is found in kidney transplant recipients, with a prevalence of 36-55%, while this rate is 15-40% in liver transplant recipients. Studies have found that 16-36% of graft losses are associated with non-adherence. The ever-growing population of transplant recipients and the limited number of transplant centers, particularly those living farther away, necessitate innovative healthcare delivery models to monitor and improve the use of transplant center resources. With the advent of smartphones and mobile medical devices, mobile health has become a popular way for healthcare professionals to manage patient care. Mobile health can serve as an adjunct method for delivering health education information, sending reminders to patients to take their medications, and implementing online education. In particular, converting paper-based education to video format can significantly increase knowledge on various topics. It is necessary to address the problems and challenges patients face after discharge and the practices that can potentially address these issues. These results suggest that healthcare professionals can do more to provide comprehensive care to patients, promote successful home-based treatment regimens, symptom control, and quality of life.

Study Overview

• Status: Not yet recruiting
• Conditions: Mobile Applications; Organ Transplantation; Nursing
• Intervention / Treatment: Other: Mobile application installation; Other: Providing teaching booklets; Other: Control

• Study Type: Interventional
• Enrollment (Estimated): 108
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rıfat GÜRKAN, Master of Science in Nursing; Phone Number: +905067154895; Email: rifatgurkannn@gmail.com

Study Locations

• Turkey (Türkiye)
  • Samsun
    • Samsun, Samsun, Turkey (Türkiye)
      • Ondokuz Mayis University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being over 18 years of age,
• Having undergone a liver or kidney transplant for the first time,
• Having been discharged at least three months ago,
• Having access to a smartphone and internet and the ability to use them independently,

Exclusion Criteria:

• Having a diagnosis of a psychiatric or neurological disorder,
• Having hearing or vision problems severe enough to impede communication,
• Requesting to leave during the research period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control	Other: Control; Transplant patients will receive standard discharge training
Experimental: Mobile applications	Other: Mobile application installation; Transplant patients will receive standard discharge training. A mobile application created by the researcher will be installed on transplant patients' phones.
Experimental: Teaching booklet	Other: Providing teaching booklets; Transplant patients will receive standard discharge training. Transplant patients will be given researcher prepared instructional booklet

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The effect of education on quality of life in organ transplant patients	The SF-36 Quality of Life Scale will be administered before the training intervention. Most questions on the scale use Likert-type rating scales (3, 5, and 6 points), while questions four and five can be answered with yes/no. Each section of the scale is rated between 0 and 100 points. Higher scores indicate better health, or improved quality of life ("0" for poor health, "100" for good health).	Baseline, and 1, 3, and 6 months post-intervention.
The effect of education on symptom control in organ transplant patients	The Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 will be administered before the training intervention. Each item on the scale corresponds to a side effect of immunosuppressive drugs, and these items have two dimensions that assess symptom occurrence and discomfort level. Symptom occurrence is scored from 1 to 5, with 1=never occurring and 5=always occurring. Symptom discomfort level is scored from 0 to 4, with 0=never causing discomfort and 4=causing extreme discomfort.	Baseline, and 1, 3, and 6 months post-intervention.
The effect of education on adherence to ımmunosuppressive therapy in organ transplant patients	The Immunosuppressant Therapy Adherence Scale in Organ Transplantation Patients will be administered before the training intervention. The scale consists of four questions, and participants can receive a score between 0 and 12. Individuals who have not forgotten their immunosuppressive treatment in the last three months are given 3 points, those with 1-20% non-adherence to immunosuppressive treatment are given 2 points, those with 21-50% non-adherence to immunosuppressive treatment are given 1 point, and those with >50% non-adherence to immunosuppressive treatment are given 0 points.	Baseline, and 1, 3, and 6 months post-intervention.

Collaborators and Investigators

• Sponsor: Ondokuz Mayıs University

Study record dates

Study Major Dates

• Study Start (Estimated): December 10, 2025
• Primary Completion (Estimated): March 10, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: December 4, 2025
• First Submitted That Met QC Criteria: December 4, 2025
• First Posted (Estimated): December 17, 2025

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 18, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: OMU-GURKAN-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No