Page 16 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint

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Chapter 1
Chapter 3. For the design and implementation of self-management support systems (SMSS), it is important to understand the factors that influence patients’ acceptance of a SMSS. In the questionnaire study described in this chapter, we identified key factors influencing renal transplant patients’ acceptance of the SMSS. The questionnaire items were developed based on literature describing factors that influence patients’ acceptance of a new system.
Chapter 4. The StatSensor® Xpress-i TM, a point-of-care system for blood creatinine measurement, offers patients the possibility to self-monitor kidney function. As this device has never been used in a kidney transplant population before, we investigated whether the StatSensor® can be applied safely for kidney transplant follow-up by examining its’ analytical performance for both detecting current renal function and monitoring renal (dys)function over time.
Chapter 5. This chapter describes the results of a randomized controlled trial (RCT) in which the safety and usability of self-monitoring creatinine and blood pressure with the support of an online SMSS during the first year post-transplantation was investigated. Self-monitoring kidney function after transplantation was compared to usual care with regard to healthcare consumption, kidney function (eGFR), blood pressure, quality of life, satisfaction and self-efficacy regarding self-management behaviour.
Chapter 6. For self-monitoring to be a safe alternative to regular face-to-face follow-up, patients have to adhere to a monitoring schedule, report test results accurately and act upon test results if these suggest graft failure may occur. We used data that was collected in the RCT to investigate level of adherence to both the self-measurement regimen and to the automatic advice patients received upon registering their creatinine measurements in the online SMSS (e.g. repeat measurement, contact the hospital) and to assess the reliability of the measurements that were registered in the SMSS.
Chapter 7. The results presented in the previous chapters and their implications are discussed in a broader context. Recommendations for future research are provided.