Improvement of Immunosuppressive Medication Adherence Using a SystemCHANGE Intervention: Case Study of an Older Adult Kidney Transplant Recipient

Cynthia L. Russell, Courtney Miller, Laura M. Remy, Jennifer L. Wessol, Angela M. Andrews, Dana Aholt, Debra Clark, Karen Hardinger, Tara O'Brien, Donna Hathaway, Kathy Goggin

Research output: Contribution to journalArticle

Abstract

This article reports a case study of an older adult kidney transplant recipient with poor medication adherence enrolled in an innovative six-month SystemCHANGE intervention that seeks to systematically improve medication adherence by identifying and shaping routines, involving others in routines, and using medication-taking feedback through small, patient-led experiments. Medication adherence increased immediately and was sustained throughout the intervention and maintenance phases. This is the first case study to demonstrate effectiveness of the SystemCHANGE intervention for promoting medication adherence in a kidney transplant recipient. The intervention improved the timing of doses by linking them to a regularly occurring behavior and providing feedback. The SystemCHANGE intervention represents a systems-thinking approach for both provider and patients, and gives healthcare providers the tools needed to assist patients in using habits and routines, and feedback to improve medication taking and timing.

Original languageEnglish (US)
Pages (from-to)171-223
Number of pages53
JournalNephrology nursing journal : journal of the American Nephrology Nurses' Association
Volume45
Issue number2
StatePublished - Mar 1 2018

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Medication Adherence
Immunosuppressive Agents
Kidney
Systems Analysis
Health Personnel
Habits
Maintenance
Transplant Recipients

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Improvement of Immunosuppressive Medication Adherence Using a SystemCHANGE Intervention : Case Study of an Older Adult Kidney Transplant Recipient. / Russell, Cynthia L.; Miller, Courtney; Remy, Laura M.; Wessol, Jennifer L.; Andrews, Angela M.; Aholt, Dana; Clark, Debra; Hardinger, Karen; O'Brien, Tara; Hathaway, Donna; Goggin, Kathy.

In: Nephrology nursing journal : journal of the American Nephrology Nurses' Association, Vol. 45, No. 2, 01.03.2018, p. 171-223.

Research output: Contribution to journalArticle

Russell, Cynthia L. ; Miller, Courtney ; Remy, Laura M. ; Wessol, Jennifer L. ; Andrews, Angela M. ; Aholt, Dana ; Clark, Debra ; Hardinger, Karen ; O'Brien, Tara ; Hathaway, Donna ; Goggin, Kathy. / Improvement of Immunosuppressive Medication Adherence Using a SystemCHANGE Intervention : Case Study of an Older Adult Kidney Transplant Recipient. In: Nephrology nursing journal : journal of the American Nephrology Nurses' Association. 2018 ; Vol. 45, No. 2. pp. 171-223.
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