Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study

Céline L van Lint,1 Paul JM van der Boog,1 Wenxin Wang,2,3 Willem-Paul Brinkman,2 Ton JM Rövekamp,3 Mark A Neerincx,2 Ton J Rabelink,1 Sandra van Dijk1,4 1Department of Nephrology, Leiden University Medical Centre (LUMC), Leiden, 2Faculty of Electrical Engineering, Mathematics a...

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Main Authors: van Lint CL, van der Boog PJM, Wang W, Brinkman WP, Rövekamp TJM, Neerincx MA, Rabelink TJ, van Dijk S
Format: Article
Language:English
Published: Dove Medical Press 2015-12-01
Series:Patient Preference and Adherence
Subjects:
Online Access:https://www.dovepress.com/patient-experiences-with-self-monitoring-renal-function-after-renal-tr-peer-reviewed-article-PPA
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author van Lint CL
van der Boog PJM
Wang W
Brinkman WP
Rövekamp TJM
Neerincx MA
Rabelink TJ
van Dijk S
author_facet van Lint CL
van der Boog PJM
Wang W
Brinkman WP
Rövekamp TJM
Neerincx MA
Rabelink TJ
van Dijk S
author_sort van Lint CL
collection DOAJ
description Céline L van Lint,1 Paul JM van der Boog,1 Wenxin Wang,2,3 Willem-Paul Brinkman,2 Ton JM Rövekamp,3 Mark A Neerincx,2 Ton J Rabelink,1 Sandra van Dijk1,4 1Department of Nephrology, Leiden University Medical Centre (LUMC), Leiden, 2Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, 3Department of Technology in Healthcare, Prevention and Health, Dutch Organization for Applied Scientific Research (TNO), Leiden, 4Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands Background: After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients’ experiences and satisfaction.Materials and methods: For 3 months after transplantation, 30 patients registered self-measured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements.Results: Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P<0.01), level of self-efficacy (P<0.01), and amount of trust in the accuracy of the creatinine meter (P<0.01). The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the accuracy of the creatinine device being relatively low. Trust in the accuracy of the creatinine device appeared to be related to level of variation in subsequent measurement results, with more variation being related to lower levels of trust. Protocol adherence was generally very high, although the range of adherence levels was large and increased over time.Conclusion: Patients’ high levels of satisfaction suggest that at-home monitoring of creatinine and blood pressure after transplantation offers a promising strategy. Important prerequisites for safe implementation in transplant care seem to be support from physicians and patients’ confidence in both their own self-monitoring skills and the accuracy of the devices used. Keywords: adherence, blood pressure, creatinine, kidney transplantation, satisfaction, self-monitoring
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spelling doaj.art-c93804224fcf4f9dba19cc2aaa751b262022-12-22T01:37:38ZengDove Medical PressPatient Preference and Adherence1177-889X2015-12-012015Issue 11721173124895Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot studyvan Lint CLvan der Boog PJMWang WBrinkman WPRövekamp TJMNeerincx MARabelink TJvan Dijk SCéline L van Lint,1 Paul JM van der Boog,1 Wenxin Wang,2,3 Willem-Paul Brinkman,2 Ton JM Rövekamp,3 Mark A Neerincx,2 Ton J Rabelink,1 Sandra van Dijk1,4 1Department of Nephrology, Leiden University Medical Centre (LUMC), Leiden, 2Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, 3Department of Technology in Healthcare, Prevention and Health, Dutch Organization for Applied Scientific Research (TNO), Leiden, 4Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands Background: After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients’ experiences and satisfaction.Materials and methods: For 3 months after transplantation, 30 patients registered self-measured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements.Results: Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P<0.01), level of self-efficacy (P<0.01), and amount of trust in the accuracy of the creatinine meter (P<0.01). The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the accuracy of the creatinine device being relatively low. Trust in the accuracy of the creatinine device appeared to be related to level of variation in subsequent measurement results, with more variation being related to lower levels of trust. Protocol adherence was generally very high, although the range of adherence levels was large and increased over time.Conclusion: Patients’ high levels of satisfaction suggest that at-home monitoring of creatinine and blood pressure after transplantation offers a promising strategy. Important prerequisites for safe implementation in transplant care seem to be support from physicians and patients’ confidence in both their own self-monitoring skills and the accuracy of the devices used. Keywords: adherence, blood pressure, creatinine, kidney transplantation, satisfaction, self-monitoringhttps://www.dovepress.com/patient-experiences-with-self-monitoring-renal-function-after-renal-tr-peer-reviewed-article-PPAAdherenceblood pressurecreatininekidney transplantationsatisfactionself-monitoring
spellingShingle van Lint CL
van der Boog PJM
Wang W
Brinkman WP
Rövekamp TJM
Neerincx MA
Rabelink TJ
van Dijk S
Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
Patient Preference and Adherence
Adherence
blood pressure
creatinine
kidney transplantation
satisfaction
self-monitoring
title Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
title_full Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
title_fullStr Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
title_full_unstemmed Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
title_short Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study
title_sort patient experiences with self monitoring renal function after renal transplantation results from a nbsp single center prospective pilot study
topic Adherence
blood pressure
creatinine
kidney transplantation
satisfaction
self-monitoring
url https://www.dovepress.com/patient-experiences-with-self-monitoring-renal-function-after-renal-tr-peer-reviewed-article-PPA
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