A heart transplant is a challenging procedure for both patients and families, but the challenge does not end when the surgery is finished. After the procedure, patients must adhere to a strict immunosuppressant therapy medication regimen to avoid graft failure, or “acute rejection”. As adolescents become independent adults, they are also learning to direct their own care and personal health decision making. This transition is challenging for everyone, especially with solid organ transplant recipients where timely dose-taking is critical. Some adolescents have non-adherence rates as high as 40% to 60% which can lead to serious complications, removal from the transplant candidate list for future transplants, and even death. To support adolescent patients and their families, emocha participated in a clinical study investigating the use of video-based technology programs to support adolescent heart transplant patients in improving medication adherence.

Improving Medication Adherence

Dr. Michael Killian, Florida State University, and Dr. Dipankar Gupta, University of Florida, piloted a digital health program – with emocha Health – to engage pediatric heart transplant recipients and promote medication adherence to critical immunosuppressant therapy. The 12-week pilot study evaluated emocha’s video Directly Observed Therapy (DOT) program. The program is designed to track and improve medication adherence in adolescent heart transplant recipients (ages 11-21) with a history of poor adherence and improve communication between patients and care teams. The emocha program allowed clinical care teams at UF, staff, and research scientists to accurately track dose-by-dose medication adherence through direct observation using the emocha mobile app.

Results of Study

Participants who completed the program reached 90.1% medication adherence and avoided poor health outcomes such as acute rejection. Not only did patients take their medications, but they also stayed closely connected with their care team. Care teams and patients exchanged 893 messages with 205 messages coming directly from adolescent participants. There were also 1,211 check-ins (out of an expected 1,344 check-ins) where patients documented taking their medication through emocha’s mobile app.

Patients and family members who used the emocha program reported high satisfaction and patient engagement. They were highly satisfied and found value in the technology as well as the interaction with and support from care team members. One of the key outcomes of the study was how simple adolescent patients found adding the DOT app and medication regime to their everyday lives. Not only was the DOT app easy to use, but patients reported it aiding medication tracking, supporting their sense of freedom during daily activities, and enriching their quality of life emotionally, physically, and academically. Both patients and parents reported appreciation for the organization, communication, and engagement offered by the app. According to parents – and similar to other emocha implementations with pediatric asthma patients – the app served as a learning tool for their children as it increased their knowledge of their condition, medication, post-transplant care, and health care decision-making.

emocha Health’s Digital Medication Adherence Program improved pediatric heart transplant patient outcomes, resulting in higher health-related quality of life, adherence barrier management, and a brighter future for adolescent transplant adherence interventions.

To learn more about the program, read the full publication here.