New Project Trains mHealth on Medication Adherence for Transplant Patients

Researchers at three health systems will soon be launching a telehealth study to determine whether transplant patients can improve their medication management through an mHealth app.

Johns Hopkins University, the University of Virginia and the University of Miami will be taking part in the pilot program, funded by a $1.5 million grant from the National Institutes of Health’s National Institute on Diabetes and Digestives and Kidney Diseases (NIDDK). The study will evaluate whether care providers can use video-based Directly Observed Therapy to ensure that kidney and liver transplant patients are taking their medications when they should.

The project is being coordinated by emocha Health, a Baltimore-based digital health company spun out of Johns Hopkins. The emocha app and telehealth platform enables patients to take a video when they take their medications and send that to their care providers, who use that platform to remotely monitor medication adherence.

"Taking medication consistently and at the right time is critical for transplant recipients in order to avoid debilitating and devastating consequences, which can include rejection, failure, or even death," emocha CEO Sebastien Seiguer said in a press release. "We know that patients face numerous challenges post-transplant, and are excited for the opportunity to partner with leaders in the field, expand our work with transplant centers, and support patients."

Healthcare providers have been testing out a wide variety of mHealth and telemedicine technology to tackle the medication management dilemma, especially with the coronavirus pandemic cutting down on in-person treatments. They’re looking for ways to remotely monitor patients taking their medications, to ensure that the medications are being taken at the right times and in the right doses and that they’re affecting clinical outcomes.

Aside from vDOT, which runs on an asynchronous telemedicine platform, other tools include real-time audio-visual communications, digital pillboxes, sensor-embedded medications and mHealth wearables that track the body’s reaction to medication.

emocha Health, whose platform has been put to the test for chronic care management (including hepatitis, tuberculosis and diabetes) and opioid abuse treatment, partnered with the Johns Hopkins University Epidemiology Research Group in Organ Transplantation (ERGOT) in 2018 to test the platform on transplant patients, who need to follow strict medication guidelines. That study led the NIDDK to fund this project.

Researchers say more than a quarter of kidney transplant patients and between 15 percent and 40 percent of liver transplant patients aren’t taking their medications as prescribed, putting them at risk of adverse effects – including hospitalization and death – and costing health systems between $4,000 and $11,000 per patient per year.

Beyond treatment for people with substance abuse issues and chronic diseases and those on transplant medications and post-discharge rehab programs, these connected health platforms also hold promise for public health programs tackling infectious diseases like HIV and AIDS and viruses.