Trial reportAmerican journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists2021
Impact of a pharmacist-led, mHealth-based intervention on tacrolimus trough variability in kidney transplant recipients: A report from the TRANSAFE Rx randomized controlled trial.
Trial report in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 7 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 7 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Effectiveness of mHealth Interventions to Improve Follow-Up and Management Among Solid Organ Transplant Recipients: Systematic Review and Meta-Analysis.JMIR mHealth and uHealth · 2025Pooled it
- Effectiveness of eHealth for Medication Adherence in Renal Transplant Recipients: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Pooled it
- The effectiveness of remote interventions based on digital health technology in kidney transplant recipients: a systematic review.World journal of urology · 2025Pooled it
- Interventions for increasing immunosuppressant medication adherence in solid organ transplant recipients.The Cochrane database of systematic reviews · 2022Pooled it
- The Effectiveness of Pharmacist Interventions in the Management of Patient with Renal Failure: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Digital Health Interventions by Clinical Pharmacists: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Exploring the pharmacist's role in regional, rural, and remote kidney transplant care: Perspectives of health professionals and transplant recipients.Exploratory research in clinical and social pharmacy · 2025Article
- Technology-Enabled Remote Patient Monitoring and Education to Improve Kidney Transplant Knowledge, Access, and Post-Transplant Care: A Narrative Review.Current transplantation reports · 2025Article
- The impact of pharmacists' interventions within the closed loop immunosuppressant management process on kidney transplant recipients: a retrospective cohort study.Frontiers in immunology · 2025Article
- Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup.Nature reviews. Nephrology · 2023Review
- The expanded role of the transplant pharmacist: A 10-year follow-up.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- The effect of pharmacist-led interventions on the management and outcomes in chronic kidney disease (CKD): A systematic review and meta-analysis protocol.Health science reports · 2023Article
- Review and Evaluation of mHealth Apps in Solid Organ Transplantation: Past, Present, and Future.Transplantation direct · 2022Review
- The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas.Pharmaceutics · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
purposeNonadherence is a leading cause of death-censored allograft loss in kidney transplant recipients. Strong associations have tied tacrolimus intrapatient variability (IPV) to degree of nonadherence and high tacrolimus IPV to clinical endpoints such as rejection and allograft loss. Nonadherence is a dynamic, complex problem best targeted by multidimensional interventions, including mobile health (mHealth) technologies.
methodsThis was a secondary planned analysis of a 12-month, parallel, 2-arm, semiblind, 1:1 randomized controlled trial involving 136 adult kidney transplant recipients. The primary aims of the TRANSAFE Rx study were to assess the efficacy of a pharmacist-led, mHealth-based intervention in improving medication safety and health outcomes for kidney transplant recipients as compared to usual care.
resultsPatients were randomized equally to 68 patients per arm. The intervention arm demonstrated a statistically significant decrease in tacrolimus IPV over time as compared to the control arm (P = 0.0133). When analyzing a clinical goal of tacrolimus IPV of less than 30%, the 2 groups were comparable at baseline (P = 0.765), but significantly more patients in the intervention group met this criterion at month 12 (P = 0.033). In multivariable modeling, variables that independently impacted tacrolimus IPV included time, treatment effect, age, and warm ischemic time.
conclusionThis secondary planned analysis of an mHealth-based, pharmacist-led intervention demonstrated an association between the active intervention in the trial and improved tacrolimus IPV. Further prospective studies are required to confirm the mutability of tacrolimus IPV and impact of reducing tacrolimus IPV on long-term clinical outcomes.
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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.