Trial reportAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2020
Improving medication adherence and outcomes in adult kidney transplant patients using a personal systems approach: SystemCHANGE™ results of the MAGIC randomized clinical trial.
Trial report in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
SystemCHANGE: An Intervention for Medication Adherence in Transplant Recipients
Medication Adherence Given Individual SystemCHANGE(TM) in Advancing Nephropathy (MAGICIAN) Pilot Study
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Educational Interventions for Haemodialysis Patients in the Transplant Process: A Systematic Review.Nursing open · 2024Pooled it
- Interventions for improving health literacy in people with chronic kidney disease.The Cochrane database of systematic reviews · 2022Pooled it
- Interventions for increasing immunosuppressant medication adherence in solid organ transplant recipients.The Cochrane database of systematic reviews · 2022Pooled it
- Efficacy of Adherence-Enhancing Interventions for Immunosuppressive Therapy in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.Frontiers in pharmacology · 2020Pooled it
- Impact of text message reminders on immunosuppressive medication adherence among kidney transplant recipients: A randomized controlled study.Journal of evaluation in clinical practice · 2025Trial
- A Pilot Randomized Controlled Trial Using SystemCHANGE™ Approach to Increase Physical Activity in Older Kidney Transplant Recipients.Progress in transplantation (Aliso Viejo, Calif.) · 2020Trial
- A nurse-led program to improve immunosuppressant medication adherence in adult kidney transplant recipients: a randomized clinical trial.BMC nursing · 2026Article
- The SystemCHANGE™ intervention improves immunosuppressive medication-taking habit: a secondary analysis of the MAGIC studies.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Article
- Assessing Risk Factors and Posttransplant Outcomes of Nonadherence Among Kidney Transplant Recipients.Transplantation direct · 2025Article
- Adherence to 6-Mercaptopurine (6-MP) and Habit Strength in Pediatric Acute Lymphoblastic Leukemia (ALL).European journal of haematology · 2025Article
- Correlation Between Objective Habit Metrics and Objective Medication Adherence: Retrospective Study of 15,818 Participants From Clinical Studies.Interactive journal of medical research · 2025Article
- Article
- Immunosuppressant nonadherence profile in kidney transplant recipients and the impact of medication adherence on transplant outcomes.Frontiers in pharmacology · 2024Article
- A concept analysis of routines for improving health behaviors.International journal of nursing sciences · 2023Review
- Post-transplant education for kidney recipients and their caregivers.Pediatric nephrology (Berlin, Germany) · 2023Review
- Managing Medications and Medication Adherence Among US Adults During the Early Phase of the COVID-19 Pandemic.Patient preference and adherence · 2023Article
- A Cost-effectiveness Analysis of Adherence Promotion Strategies to Improve Rejection Rates in Adolescent Kidney Transplant Recipients.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Detecting, preventing and treating non-adherence to immunosuppression after kidney transplantation.Clinical kidney journal · 2022Review
- A Multifaceted Intervention to Improve Medication Adherence in Kidney Transplant Recipients: An Exploratory Analysis of the Fidelity of the TAKE IT Trial.JMIR formative research · 2022Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
This study determined if a SystemCHANGE™ intervention was more efficacious than attention control in increasing immunosuppressive medication adherence and improving outcomes in adult kidney transplant recipients during a 6-month intervention phase and subsequent 6-month (no intervention) maintenance phase. The SystemCHANGE™ intervention taught patients to use person-level quality improvement strategies to link adherence to established daily routines, environmental cues, and supportive people. Eighty-nine patients (average age 51.8 years, 58% male, 61% African American) completed the 6-month intervention phase. Using an intent-to-treat analysis, at 6 months, medication adherence for SystemCHANGE™ (median 0.91, IQR 0.76-0.96) and attention control (median 0.67, IQR 0.52-0.72) patients differed markedly (difference in medians 0.24, 95% CI 0.13-0.30, P < .001). At the conclusion of the subsequent 6-month maintenance phase, the gap between medication adherence for SystemCHANGE™ (median 0.77, IQR 0.56-0.94) and attention control (median 0.60, IQR 0.44-0.73) patients remained large (difference in medians 0.17, 95% CI 0.06-0.33, P = .004). SystemCHANGE™ patients evidenced lower mean creatinine and BUN at 12 months and more infections at 6 and 12 months. This first fully powered RCT testing SystemCHANGE™ to improve and maintain medication adherence in kidney transplant recipients demonstrated large, clinically meaningful improvements in medication adherence. Clinical Trial Registration: NCT02416479.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.