Development and Testing of a Digitally Enabled Adherence Platform

Abstract

Objective:

To develop a digitally enabled adherence platform (DEAP) using evidence-based adherence promotion strategies through iterative testing with patients, design specialists, and adherence experts.

Method:

Adolescents and young adults (AYAs) with a kidney transplant from a large, midwestern transplant program were recruited to participate in this study. Through an iterative process, we conducted focus groups, individual interviews, empathy interviews/mapping, and usability testing and evaluation to develop and refine the initial version of DEAP.

Results:

Three empathy maps were created to assess the unique needs of patients, caregivers, and healthcare providers. Eleven patients were then recruited to participate in usability testing of the platform. Platform engagement was high with nine of the 11 participants viewing their initial messages/surveys, usability was rated as high (M = 81.88, SD = 9.61, range = 67.5–95.0), and user-friendliness was rated as excellent (M = 5.88, SD = 0.74, range = 5.0–7.0). Participants also noted multiple opportunities for improving the look and design of DEAP.

Conclusions:

Engaging with multiple stakeholders and piloting a small usability study have demonstrated support for the acceptability and usability of DEAP, a mobile health platform to address barriers to taking immunosuppression medication for AYAs who have received kidney transplants. Future work is planned to develop a better patient and clinician user experience, increase personalization, and facilitate patient–clinician engagement using this platform.

Implications for Impact Statement

Up to 40% of adolescents and young adults (AYAs) who have undergone kidney transplants do not take their immunosuppression medication as prescribed, which can lead to devastating consequences including organ rejection. DEAP (digitally enabled adherence platform), a web-based system, was designed using an iterative process with input from key stakeholders with features to assess adherence barriers and provide solutions through problem-solving. Preliminary usability testing suggests it is acceptable and easy to use, demonstrating its potential to address suboptimal adherence and improve health outcomes.