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Trial registered on ANZCTR
Registration number
ACTRN12614000608662
Ethics application status
Approved
Date submitted
3/06/2014
Date registered
6/06/2014
Date last updated
31/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Improving medicine adherence in kidney transplantation
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Scientific title
In adults more than one month post-kidney transplantation, is a multi-factorial intervention including medicine review, DVD and health coaching more effective than usual care in improving immunosuppressant medicine adherence?
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Secondary ID [1]
284743
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Nil known
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Universal Trial Number (UTN)
U1111-1157-5996
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
End-stage kidney disease requiring kidney transplantation
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Condition category
Condition code
Renal and Urogenital
292404
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All participants in the intervention group will receive a once only, one hour home visit comprising a home medicine review and a ten minute DVD to motivate people to take their medicines.
Fortnightly ten minute telephone health coaching for three months will be conducted.
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Intervention code [1]
289499
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Behaviour
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Comparator / control treatment
Ongoing medical care provided to a patient who has received a kidney transplant attending routine outpatient clinic follow up and primary care
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Control group
Active
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Outcomes
Primary outcome [1]
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7% improvement in immunosuppressant medicine adherence compared to ‘usual care’ in kidney transplantation measured by the Medication Event Monitoring System, laboratory tests, prescription refill and self-report.
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Assessment method [1]
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Timepoint [1]
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Outcomes will be assessed at baseline, 3, 6 and 9 months.
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Secondary outcome [1]
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Medicine adherence will be set at equal to or >80% for all other medicines assessed by prescription refill, laboratory tests, and self-report.
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Assessment method [1]
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Timepoint [1]
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Outcomes will be assessed at baseline, 3, 6 and 9 months.
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Eligibility
Key inclusion criteria
Comprehend English, and prescribed immunosuppressant medicines in kidney transplantation
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Adults living in supported accommodation (medicines are managed by staff)
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be recruited by the PhD student and Research Fellow at kidney transplant outpatient clinics with the assistance of the renal transplant coordinators and nephrologists at the five sites. People who express interest in participating in the study will be visited in their homes for informed consent and enrolment by the Research Fellow. Each patient will be given a code number which will be given to the off-site statistician for treatment allocation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Centralised, stratified randomisation of participants based upon the site (5 sites involved)
Off-site statistician prepares an excel file containing a sheet for each of the five sites containing the randomisation list and unique randomisation number and treatment allocation in sequential order
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Intention-to-treat. Descriptive statistics will be used to compare baseline characteristics. Categorical data will be presented as frequencies and percentages. Normally distributed data will be presented as means and standard deviations and non-symmetrical data as medians and inter-quartile ranges. The primary analysis will be based on the follow-up data by assessing the difference in adherence based on the MEMS score using a linear mixed-effects model. This model will accommodate for the unequal variances in repeated measurements while adjusting for random effects of participant. Secondary analyses, including medication adherence measured using surrogate and self-reported measures of medication adherence will be analysed using linear mixed-effects model for continuous variables and generalized estimated equation for binomial outcomes.
To estimate the sample size we wish to detect an increase of 7% in the MEMS score in the intervention group, allowing for a standard deviation of 9% in each group. Assuming a two-tailed hypothesis test with significance level of 5% and a power of 80%, we estimate at least 27 patients are required in each group. Taking into consideration an attrition rate of 20%, the number required is 32 per group, making a total sample of 64 participants. Our preliminary work with our partner investigators have suggested that attrition is likely to be higher based on their experience with this group of patients.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
11/08/2014
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Actual
22/09/2014
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Date of last participant enrolment
Anticipated
9/10/2015
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Actual
13/10/2015
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Date of last data collection
Anticipated
30/11/2016
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Actual
13/01/2017
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Sample size
Target
64
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Accrual to date
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Final
71
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred - Prahran
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Recruitment hospital [2]
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Austin Health - Austin Hospital - Heidelberg
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Recruitment hospital [3]
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment hospital [4]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment hospital [5]
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health & Medical Research Council Partnership project
APP1056717
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Address [1]
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Level 1, 16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
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Australia
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Funding source category [2]
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University
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Name [2]
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Monash University
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Address [2]
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Wellington Road
Clayton VIC 3800
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Country [2]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Monash Nursing Academy
Monash University School of Nursing and Midwifery
Clayton Campus
Building 13D Level 3,
Wellington Rd
Clayton VIC 3800
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
288019
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Country [1]
288019
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash Health HREC B
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Ethics committee address [1]
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Monash Health Monash Medical Centre 246 Clayton Road Clayton VIC 3168
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291100
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Approval date [1]
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04/07/2013
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Ethics approval number [1]
291100
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HREC/13/SHB/10
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Ethics committee name [2]
291101
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Monash Health Research Governance
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Ethics committee address [2]
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Monash Health Monash Medical Centre 246 Clayton Road Clayton VIC 3168
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
291101
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Approval date [2]
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23/07/2013
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Ethics approval number [2]
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HREC/13/SHB/10 (local reference number: 13176B)
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Ethics committee name [3]
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Austin Health Research Governance
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Ethics committee address [3]
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145 Studley Road PO Box 5555 Heidelberg VIC 3084
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
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Approval date [3]
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23/10/2013
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Ethics approval number [3]
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HREC/13/SHB/10 (local reference number: SSA/13/Austin/83)
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Ethics committee name [4]
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Melbourne Health Research Governance
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Ethics committee address [4]
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Royal Melbourne Hospital Parkville VIC 3052
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Ethics committee country [4]
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Australia
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Date submitted for ethics approval [4]
291103
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Approval date [4]
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25/09/2013
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Ethics approval number [4]
291103
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HREC/13/SHB/10 (local reference number: 2013.142)
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Ethics committee name [5]
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Alfred Health Research Governance
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Ethics committee address [5]
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Alfred Health 55 Commercial Road PO Box 315 Prahran VIC 3181
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Ethics committee country [5]
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Australia
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Date submitted for ethics approval [5]
291104
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Approval date [5]
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29/11/2013
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Ethics approval number [5]
291104
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HREC/13/SHB/10
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Ethics committee name [6]
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St. Vincent's Hospital (Melbourne) Research Goverenance
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Ethics committee address [6]
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St. Vincent's Hospital (Melbourne) 41 Victoria Parade PO Box 2900 Fitzroy VIC 3065
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Ethics committee country [6]
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Australia
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Date submitted for ethics approval [6]
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Approval date [6]
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07/01/2014
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Ethics approval number [6]
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HREC/13/SHB/10 (local reference number: HREC-D094/13)
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Ethics committee name [7]
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Monash University HREC
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Ethics committee address [7]
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Monash University HREC Building 3E Wellington Road Clayton VIC 3800
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Ethics committee country [7]
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Australia
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Date submitted for ethics approval [7]
291109
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Approval date [7]
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20/08/2013
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Ethics approval number [7]
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CF13/2440-2013001269
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Summary
Brief summary
More people require kidney transplants which are in short supply. It is imperative that people who have kidney transplants take their medicines as prescribed. Poor adherence to prescribed medicines can cause a 60% increased risk of kidney transplant failure. Rejection requires costly hospitalisations, laboratory tests and anti-rejection therapies with associated poor outcomes. This project will develop and test an intervention to help adults requiring a kidney transplant to take their medicines as prescribed. Better medicine adherence results in improved graft life, general well-being, and reduced health care expenditure. Our industry partners share this vision of improved health for people requiring kidney transplantation.
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Trial website
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Trial related presentations / publications
i. Low, JK., Williams, A., Manias, E., & Crawford, K. (2016) How to create a well-received consumer-centred video to support medication adherence in kidney transplantation. The Transplant Nurses Association National Conference in Adelaide. October 21st, 2016. Oral presentation. Best paper ii. Low, JK., Williams, A., Manias, E., & Crawford, K. (2016) Patients’ stories: can this insider view be used to support medication adherence in kidney transplantation? The International Society for Quality in Health Care’s 33rd International Conference in Tokyo. October 19th, 2016. Oral presentation.
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Allison Fiona Williams
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Address
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Monash Nursing Academy
Monash University School of Nursing and Midwifery
Clayton Campus
Building 13D Level 3,
Wellington Rd
Clayton VIC 3800
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Country
48878
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Australia
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Phone
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+ 61 3 9904 4377
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Fax
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+ 61 3 9905 4837
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Email
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[email protected]
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Contact person for public queries
Name
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Allison Fiona Williams
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Address
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Monash Nursing Academy
Monash University School of Nursing and Midwifery
Clayton Campus
Building 13D Level 3,
Wellington Rd
Clayton VIC 3800
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Country
48879
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Australia
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Phone
48879
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+ 61 3 9904 4377
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Fax
48879
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+ 61 3 9905 4837
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Email
48879
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[email protected]
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Contact person for scientific queries
Name
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Allison Fiona Williams
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Address
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Monash Nursing Academy
Monash University School of Nursing and Midwifery
Clayton Campus
Building 13D Level 3,
Wellington Rd
Clayton VIC 3800
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Country
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Australia
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Phone
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+ 61 3 9904 4377
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Fax
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+ 61 3 9905 4837
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Nephrologists' management of patient medications in kidney transplantation: Results of an online survey.
2015
https://dx.doi.org/10.1111/jep.12394
N.B. These documents automatically identified may not have been verified by the study sponsor.
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