Improvement of Immunosuppressive Medication Adherence Using a SystemCHANGE Intervention: Case Study of an Older Adult Kidney Transplant Recipient.
Cynthia L Russell, Courtney Miller, Laura M Remy and 8 others
PMID 30303638WHAT IT FOUND
One older kidney transplant recipient improved her medication adherence from 74% to 90% by setting cell phone alarms and carrying a travel pill case.
These small environmental changes helped her take doses on time, but the study cannot prove this works for others.
Key findings
01The participant's medication adherence score increased from 74% during screening to 90% in the first month of the intervention.
02The participant maintained adherence scores between 90% and 100% throughout the intervention and maintenance phases.
03The two solutions implemented were setting a cell phone alarm for medication times and carrying a travel pill case for when out of the home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a single case report, so the findings cannot be generalized to other patients. The participant had high baseline social support and self-efficacy, which may have contributed to her success independent of the intervention. There was no control group, so it is impossible to know if the improvement was due to the intervention or other factors. The authors noted that researcher familiarity with the participant could affect objectivity, although the main outcome was measured objectively by the MEMS cap.
Declared interests
The authors reported no actual or potential conflicts of interest.
The easy way to misread this
Do not assume this intervention will improve adherence for your patients. This result comes from one person who already had strong social support and confidence, and the study design cannot prove that the SystemCHANGE methods caused the improvement.