Adoption of a Novel Smart Mobile-Health Application Technology to track chronic Immunosuppression adherence in Solid Organ Transplantation. Results of a Prospective, Observational, Multicentre, Pilot Study.

BACKGROUND Low adherence to chronic immunosuppression is associated with suboptimal transplantation outcomes. Mobile-Health technology is a promising tool to monitor medication adherence, but data on patient engagement to these tools are lacking. METHODS Prospective, observational, multicentre, 2-phase trial in kidney and liver transplant recipients, investigating the degree of engagement to TrackYourMed® (TYM), a novel m-Health technology with a QR code-scan app to track immunosuppression adherence and its association with drug monitoring. RESULTS Out of 204 consecutive transplant patients, 90 patients were eligible to participate. 61 (68%) used TYM regularly, 21 (23%) never or barely used it, 5 (5.5%) were irregular users, and 3 (3.3%) were lost to follow-up. 6-month total correct intakes (CIN) ranged between 69-76%, 12-19% intakes were out-of-time (OUT), and 9-12% were missed (MIS). Notably, a rate of intakes out of the scheduled time higher than 20% in the 6 days prior to blood immunosuppressant trough levels was associated with a higher intra-patient variability (17 IQR 13-21% vs 29 IQR 23-36%, p=0.001), and with a higher dose-adjustment (p<0.001). At 1 year, 53(59%) patients were still active users of TYM. CONCLUSIONS Implementing m-Health technologies promoting immunosuppression adherence may be useful for a relevant number of transplant patients and help transplant physicians identifying erratic immunosuppression adherence.