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Effects of eHealth Interventions on improving medication adherence in kidney Transplant Recipients: A Systematic Review and Meta-analysis of Randomized Controlled Trials
  • liu yue,
  • yun Zhang,
  • hong Guan
liu yue

Corresponding Author:[email protected]

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Aims Immunosuppressant non-adherence is a prevalent problem leading to many adverse outcomes in Renal transplant recipients. eHealth has the potential to improve medication compliance, but evidence in kidney transplantation remains unclear. This review aims to explore the effects of eHealth interventions on improving medication compliance in Kidney transplantation. Methods A systematic search was conducted of the following databases: PubMed, Embase, Cochrane Library, CINAHL, and Web of Science Core Collection. The search included studies published up to July 22, 2021. Two authors selected relevant studies and extracted data independently. The quality of the literature was evaluated using the Cochrane collaborative bias risk tool. To estimate the effect size, a meta-analysis of the studies was performed using the Cochrane Collaboration software Review Manager 5.3 PRISMA guidelines were followed. Results Nine studies involving 777 patients were included. Compared with control group, eHealth interventions improved medication adherence measured by electronic monitoring (RR=1.46, 95%CI, 1.11 to 1.90, p=0.006) and decreased rejection (RR=0.38; 95%CI, 0.15 to 0.97, p=0.04). There was no difference in medication compliance measured by BAASIS (RR=1.03, 95% CI, 0.88 to 1.21, p=0.72), Tacrolimus level (MD=0.16, 95%CI, -0.21 to 0.52, p=0.39), coefficient of variation of tacrolimus level (MD=-0.01, 95%CI, -0.05 to 0.02, p=0.41), and kidney function (MD=-0.44, 95% CI, -8.32 to 7.43, p=0.91) between the two groups. Conclusions eHealth interventions can improve medication adherence in kidney transplantation in the short time. However more high-quality intervention studies need performing to determine whether eHealth improves long-term adherence and clinically relevant outcomes.