Comparing Methods for Tracking Health Information at Home After Lung Transplant

Lung transplant recipients (LTR) experience more transplant-related complications, higher
health resource utilization, and higher mortality than recipients of other solid organs.
Prevention and detection of early complications is known to reduce the likelihood of future
impairments in lung function and, therefore, morbidity and mortality. Despite the scarce
donor organs and financial resources expended to support individuals throughout the lung
transplant experience, no randomized controlled trials (RCT) have tested interventions
designed to promote self-care behaviors with the aim of improving transplant-related health
after lung transplant. The purpose of this RCT is to compare the efficacy of a novel
behavioral intervention, Pocket PATH (Personal Assistant for Tracking Health) for promoting
self-care and improving health outcomes relative to standard care after lung
transplantation. Pocket PATH provides LTR a hand-held device with customized data recording,
trending, and decision-support programs to promote their self-care behaviors. Based on the
promising results from our early trials, a full-scale RCT has been designed to rigorously
test the efficacy of Pocket PATH in promoting self-care agency, self-care behaviors, and
hence improving transplant-related health. A sample of 214 LTR who survive the immediate
intensive care unit recovery period will be randomly assigned to either the intervention
group, who will be instructed to use the Pocket Path device and its programs designed for
self-monitoring, adhering to the regimen, and communicating condition changes to the
transplant team, or the control group who will receive standard instructions regarding the
post-transplant regimen (including health monitoring). Information will be collected from
participants at baseline and 1 week, 2, 6, and 12 months after discharge from the hospital
following lung transplantation. Longitudinal, repeated-measures models with planned
comparisons will be used to test the hypotheses for the primary aims. It is hypothesized
that subjects in the Pocket PATH group will develop higher levels of self-care agency and
perform self-care behaviors more often than subjects in the control group and, therefore,
will experience fewer transplant-related complications, re-hospitalizations, and better
health related quality of life.