Abstract
Non-compliance of immunosuppression after lung-transplantation provokes rejection, infection and renal insufficiency. This study was carried out to determine whether tablet-pc education is non-inferior to conventional, face-to-face, education by a specialist for improvement of immunosuppression levels after lung-transplantation.
A single-centre (Medical School of Hannover), randomised controlled trial with 6 months follow-up, including patients with less than 50% of calcineurin inhibitor trough levels in target range in last 6 months was initiated.
64 patients were randomised, stratified only by underlying disease of cystic fibrosis. 6 months after inclsuion, mean improvement of a single education was 26% of calcineurin inhibitor trough levels in target range. Primary end-point of non-inferiority was reached, a two-sided t-test revealed no difference between types of education (p = 0.17, see figure 1). Trough level variability decreased (tablet-pc: 22.9% and 17.9% conservative, p = 0.13), interval adherence remained unchanged. Knowledge about immunosuppression improved after 6 months by 44%. Instruments to measure compliance (ITBS, Morisky, ECS) demonstrated good compliance without showing differences between the groups.
Conclusion: Tablet-pc education was non-inferior to conventional education with impressive improvement after one education.
- © 2013 ERS