Peers for Promoting Adolescent Transplant Health
| Status: | Completed |
|---|---|
| Healthy: | No |
| Age Range: | 14 - 23 |
| Updated: | 5/18/2018 |
| Start Date: | September 2011 |
| End Date: | March 29, 2017 |
A Peer Mentoring Intervention to Improve Adherence and Quality of Life in Adolescents With Solid Organ Transplants
Adolescents with solid organ transplants have poorer outcomes than adults, and do not respond
as well to post-rejection treatment. In addition to well-recognized declines in individual
health-related quality of life, premature graft loss creates considerable health and economic
burdens. High nonadherence rates among adolescents are believed to contribute majorly to
rejection, premature allograft dysfunction and failure. Studies suggest that a
telephone-based peer mentoring approach, with texting and e-communication, is a promising,
practical means to promote medication adherence in adolescent solid organ transplant
recipients. The study's main objectives are 1) to determine the efficacy of peer mentoring to
improve medication adherence and health-related quality of life vs. usual care in adolescents
and young adults with solid organ transplants, and 2) to determine the mechanisms through
which peer mentoring impacts medication adherence and health-related quality of life.
as well to post-rejection treatment. In addition to well-recognized declines in individual
health-related quality of life, premature graft loss creates considerable health and economic
burdens. High nonadherence rates among adolescents are believed to contribute majorly to
rejection, premature allograft dysfunction and failure. Studies suggest that a
telephone-based peer mentoring approach, with texting and e-communication, is a promising,
practical means to promote medication adherence in adolescent solid organ transplant
recipients. The study's main objectives are 1) to determine the efficacy of peer mentoring to
improve medication adherence and health-related quality of life vs. usual care in adolescents
and young adults with solid organ transplants, and 2) to determine the mechanisms through
which peer mentoring impacts medication adherence and health-related quality of life.
The investigators will conduct a single-center Phase II randomized clinical trial in which
adolescents ages 14-23 and greater 3 months post solid organ transplant will receive either a
peer mentor or usual care. The investigators will assess changes in quality of life from
baseline to one year post-study entry. The investigators will also examine adherence changes
over the same time frame using pharmacy refill data and a questionnaire. Peer mentors will
provide social support and promote subject self-efficacy primarily via e-communication.
Changes in social support and self-efficacy will be measured over a one-year period.
adolescents ages 14-23 and greater 3 months post solid organ transplant will receive either a
peer mentor or usual care. The investigators will assess changes in quality of life from
baseline to one year post-study entry. The investigators will also examine adherence changes
over the same time frame using pharmacy refill data and a questionnaire. Peer mentors will
provide social support and promote subject self-efficacy primarily via e-communication.
Changes in social support and self-efficacy will be measured over a one-year period.
Inclusion Criteria:
- Males or females age 14 to 23 years
- Greater than one year post kidney, heart or liver transplant
- Able to speak and read in English
- Willing and able to provide informed consent or assent
- Parental guardian permission (informed consent) if appropriate
Exclusion Criteria:
- Unwilling to participate
- Unable to speak or read in English
- Unable to provide informed assent or consent
- Estimated glomerular filtration rate (eGFR) less than 20 ml/min/1.73m^2
- On dialysis
- Less than three months post transplant
- Post-transplant lymphoproliferative disease
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Children's Hospital of Philadelphia Since its start in 1855 as the nation's first hospital devoted...
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