Author, year | Study design | Included patients/analyzed patients (I, C) | Setting and region | Patient characteristics (intervention/control or whole population) | Medication (dosing frequency) | Intervention | Control | Intervention period; observation period |
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Annunziato 2015 | Cohort study (retrospective chart review) | Included n = 25 Analyzed n = 22 (12, 10) | Two pediatric and adult kidney transplant service; USA | Age (mean, years) 21.68/21.03 Male 42%/40% White 25%/0 African American 17/10 Hispanic 17%/70% Asian 33%/0 Other race 8%/20% Glomerular 64%/13% Non-glomerular 36%/88% Standard deviation of tacrolimus blood levels (mean) 1.98/2.42 | NR | Auspices of the transition coordinator Identifying and addressing gaps in self-management Discussing transfer process including fears and concerns with patient and patient’s family members Solving identified problems with patient, patient’s family, and team members Facilitating last appointment in pediatrics Completing “transition checklist” during last visit in pediatrics Providing patient and patient’s family with information about their soon-to-be adult providers Sharing impressions with members of adult team | Standard care | 1 year; 1 year |
Breu-Dejean 2016 | RCT | Included n = 110 (55, 55) Analyzed n = NR (12, 10) | Outpatient clinic at Toulouse University Hospital; Toulouse, France | Age (mean, years) 49.7/47.9 Number of immunosuppressants (mean) 2.8/2.7 Male 56.4%/49.1% Single 27.3%/34.5% Adherence score at first evaluation (mean) 29.9/32.0 | Cyclosporine (dosing NR), Sirolimus (dosing NR), Tacrolimus (dosing NR), Mycophenolate mofetil (dosing NR), Enteric-coated mycophenolate sodium (dosing NR), Prednisone (dosing NR), Azathioprine, Everolimus (dosing NR) | Psychoeducational intervention (every week) Conducted by a multidisciplinary team that included 1 physician, 1 psychologist, 2 nurses, 1 kinesiotherapist, 1 dietician, and 1 social worker Main objectives: to provide information about disease and to translate this information into a form that enabled to gain increased competence during normal daily life | Standard care | 8 weeks; 10 years |
Chisholm 2001 | RCT | Randomized n = 24 (12, 12) Analyzed n = 24 (12, 12) | Medical College of Georgia (MCG) Hospital and Clinics in Augusta, Georgia, USA | Age (mean, years) 49.2 (10.2) Male 75% Caucasian 58.3% African–American 37.5% Hispanic 4.2% | Cyclosporine (dosing NR) Tacrolimus (dosing NR) | Clinical pharmacy services Medication histories and reviews (monthly) Clinical pharmacist: counseling patients (verbally/written) concerning medications, recommendations to nephrologists, contact number given to patients Assessment of patient understanding of medication therapy Clinical pharmacist-patient interaction by telephone, if patient had no clinic visit within 1 month | Routine clinic services | 1 year; 1 year |
Chisholm 2013 | RCT | Randomized n = 150 (76, 74) Analyzed n = 150 (76, 74) | Southwest USA; Avella Specialty Pharmacy | Age (mean, years) 52.78/51.32 Annual income (mean, $) 39,673.96/28,290.44 Males 56.6%/55.4% White 77.6%/82.4% African–Americans 15.8%/14.9% Hispanic 71.1%/68.9% Married 40.8%/48.6% | Cyclosporine (dosing NR) Tacrolimus (dosing NR) | Standard specialty pharmacy care + Individual behavioral adherence contracts (goal setting, motivation, social support, memory techniques, problem-solving, consequences of non-adherence) discussed with pharmacist every 3 months to discuss new goals etc. | Standard specialty pharmacy care Mail or telephone reminders of monthly medication refills and an adherence ‘packet’ consisting of adherence-focused educational pamphlets and a pillbox | 1 year; 1 year |
De Geest 2006 | (Pilot) RCT | Randomized n = 18 (6, 12) Analyzed n = 13 (4, 9) | University Hospital Basel, Switzerland and Cantonal Hospital, Aarau, Switzerland | Non-adherent renal transplant recipients (identified in a previous study) Age (mean, years) 45.6 Male 78.6% | Cyclosporine, Mycophenolae-Mofetil, Tacrolimus, Sirolimus (dosing: twice daily) Azathioprin/Prednisone (dosing: once daily) | Enhanced usual care 1 home visit with assessment of reasons for adherence using EM printouts and tailored and individualized (behavioral, educational, and social support) interventions + 3 monthly telephone interviews (EM printouts for problem detection, feedback and proxy goal setting) | Enhanced usual care Treating physicians were informed if their patients were identified as being non-adherent or if a moderate or severe depression or suicidal ideation was suggested | 3 months; 9 months |
Fennell 1994 | Non-randomized trial (matched according to age and sex) | Included n = 29 (14, 15) Analyzed n = NR | University of Florida; USA | Age (mean, years) 12.0 Male 59% European-Amerikan 72% African- or Latino-American 28% | NR | Family-based program Educational booklet with information about transplantation; Peer modeling videotape (with discussions about the need for compliance, benefits of a kidney transplant, and strategies for remembering to take medications) Medication calendar to record medication compliance Weekly rewards to the children from their parents | Usual care | NR; NR |
Garcia 2015 | RCT | Included n = 111 (55, 56) Analyzed n = 111 (55, 56) | Universidade Estadual Paulista; Botucatu; Brasil | Age (mean, years) 46.0/49.3 Male 56.4%/62.5% | Tacrolimus (dosing NR), Cyclosporine (dosing NR), Mycophenolate (dosing NR), Azathioprine (dosing NR), Prednisone (dosing NR) | Usual care Education/counseling sessions aimed at improving delivered by a single healthcare professional with expertise in renal transplantation (10 weekly sessions, 30 min each); diverse topics which included information about the importance of taking immunosuppressive drugs even when the graft function is normal, using a non-judgmental approach to discussing adherence and tools to integrate medication intake with the patient’s daily routine | Usual transplant patient education by the medical team regarding the immunosuppressant drugs in their first outpatient assessment after discharge | 3 months; 1 year |
Hardstaff 2003 | RCT | Randomized n = 75 Analyzed at first outpatient visit: n = 48 (23, 25) Analyzed at period after feedback: n = 40 (20, 20) | NR | Stable (>1 year post-transplant) renal transplant patients | Prednisolone/Azathioprine (dosing: once daily) | Feedback about self-medication behavior at first outpatient clinic visit | Usual care | Unique at first outpatient visit (2–6 months); 4–12 months (depending on first outpatient visit) |
Henriksson 2016 | RCT | Included n = 80 (40, 40) Analyzed n = 80 (40, 40) | Karolinska University Hospital; Stockholm, Sweden | Age (mean) 44.3/45.0 Male 27/25 | Tacrolimus (dosing: twice daily, or in “slow release” form once daily), cyclosporine (dosing: twice daily) | Electronic medication dispenser (EMD) Loaded with a week’s worth of medication at a time At the prescribed time for taking the medication visual and audible signals After signals this (or after the medication was taken), the EMD sent an SMS message to the web-based software, thus providing information about patient compliance Provider reviewed medication history | Standard care | 2 years; 1 year |
Joost 2014 | Non-concurrent cohort study | Included n = 74 (39,35) Analyzed n = 67 (35, 32) | Erlangen University Hospital, Germany | Age (mean, years) 51/54 Male 77%/62 Married 83%/82% | Tacrolimus/Cyclosporin/Mycophenolic acid (dosing: twice daily) | Intensified Care Group Standard care + pharmaceutical care: ≥ 3 counseling sessions including educational, behavioral and technical interventions (during week 1–2), further counseling sessions during follow-up visits throughout the 12 months (≥ 1 quarterly; ≤ 1 monthly), encouraged to contact the pharmacist via phone or email | Standard Care Group Handout explaining post-transplant medication + 1–2 individual standardized training sessions (during 1–2 week) + scheduled follow-up visits | 12 months; standard care 2 weeks |
Russel 2011 | (Pilot) RCT | Randomization n = 15 (8, 7) Analyzed n = 13 (8, 5) | Tertiary care transplant centre; Midwestern USA | Medication non-adherent (taking < 85% of doses before inclusion) Age (mean, years) 12.1/15.7 Male 50%/43% Caucasian 100%/57% Education level (some high school/high school) 63%/14% Married 75%/43% Pillbox use 88%/29% | ≥ 1 immunosuppressive medication (medication not specified; dosing: twice daily) | Continuous self-improvement intervention Identification of life routines, important people, and possible solutions to enhance medication taking Individual monthly medication taking feedback Focus on changing the systems in which the person lives using the plan-do-check-act process | Attention control intervention Monthly educational brochures Telephone calls to review the information and to ask participants whether they have any questions about the information | 6 months; 6 months (plus prior 3 months adherence screening phase) |
Tschida 2013 | Cohort study (retrospective claims analysis) | Before propensity score matching n = 1830 Propensity-matched sample n = 1038 (519 pairs) | Mandatory program for the commercial employers of UnitedHealthcare, USA | UnitedHealthcare enrollees receiving pharmacy and medical benefits through UnitedHealthcare | ≥ 1 prescriptions for an oral transplant study drug (dosing NR) | Specialty pharmacy program Extensive patient education materials Monthly proactive adherence program: refill reminder, adherence screening, and if non-adherent interventions with members and physicians Transplant clinical management program: telephonic patient education, assessment of clinical status, pharmaceutical care intervention Contact number 24 h available | No intervention | 1 year; 1 year after index date (the first immunosuppressive drug prescription fill date) |