System for integrated adherence monitoring: real-time non-adherence risk assessment in pediatric kidney transplantation

Pediatric Transplantation
Ahna L H PaiJens Goebel

Abstract

This study reports initial results of the development of the SIAM, a non-adherence risk assessment system for tacrolimus and sirolimus for the pediatric kidney transplant population. Forty-eight youths between 10 and 25 yr of age diagnosed with chronic kidney disease or a kidney transplant used an electronic pill bottle (EM; time stamps each bottle opening) to dispense their medication for at least 30 days or until their next clinic appointment. Youth also completed a self-report adherence measure, and standard deviations were calculated for the last four medication serum trough levels obtained for each patient. Estimation models were developed for each medication (i.e., SIAM(TACRO) and SIAM(SIRO) ) to assign weights to these clinically available adherence measures (self-report and trough levels) for the calculation of a non-adherence risk composite score. SIAM(TACRO) models included both self-report and tacrolimus trough levels and significantly predicted EM. For sirolimus, the model predictive of adherence as measured by EM consisted of the standard deviation of sirolimus trough levels only (SIAM(SIRO) ). Non-adherence risk can be effectively assessed using clinically available assessment tools. However, the best methods for ...Continue Reading

References

Feb 12, 2004·Pediatric Transplantation·Richard J ShawMinnie Sarwal
Dec 16, 2004·Pediatric Transplantation·Eyal Shemesh
Jan 16, 2008·Pediatric Transplantation·Nataliya ZelikovskyKevin E C Meyers
Feb 26, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P Schäfer-KellerS De Geest
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Apr 28, 2011·JAMA : the Journal of the American Medical Association·Avani C ModiTracy A Glauser

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Citations

Sep 2, 2014·BMC Nephrology·Bethany J FosterUNKNOWN TAKE-IT Study Group
May 23, 2014·The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists·Kitty AndersonBrian J Gates
Sep 4, 2012·Journal of the American Medical Informatics Association : JAMIA·Keith Marsolo
Dec 17, 2015·Pediatric Transplantation·Lara Danziger-IsakovUNKNOWN CTOTC-05 Consortium
Jun 17, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Supelana ChristinaEyal Shemesh
May 8, 2014·Pediatric Transplantation·Debra S LefkowitzJo Wray
Aug 27, 2015·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Rachel A AnnunziatoJeffrey Saland
Jun 12, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Helen P PizzoEileen W Tsai
Mar 23, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E ShemeshB L Shneider
Apr 12, 2012·Pediatric Transplantation·Jens Goebel, Ahna Pai
Aug 18, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Cozumel S PruetteKristin A Riekert
Nov 2, 2020·Pediatric Transplantation·Jamie L RyanRyan T Fischer

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