关键词: 肾移植, 免疫抑制剂, 服药依从性, 远程医学, 电子健康, 系统评价

Abstract:

Objective To investigate the effects of eHealth interventions on improving adherence to immunosup-pressive medications in renal transplant recipients. Methods A systematic search was conducted in PubMed,Embase,Cochrane Library,CINAHL,Web of Science,CNKI,Wanfang,and VIP databases for randomized controlled trials of eHealth interventions on immunosuppressant medication adherence in renal transplant recipients from the establishment of the database to December 16,2021. Two researchers independently searched and screened the articles and extracted data. Study quality was assessed by the Cochrane quality evaluation manual. Meta-analysis was performed by using RevMan5.3 software. Results There were 8 studies involving 791 kidney transplantation recipients. The eHealth interventions improved medication adherence monitored by electronic devices compared to controls[RR=1.46,95%CI（1.11,1.90）]. However,medication adherence as assessed by the Basel Assessment of Adherence to Immunosuppressive Medication Scale [RR=1.05,95%CI（0.92,1.20）],Tacrolimus blood levels [SMD=0.16,95%CI（-0.21,0.52）],Tacrolimus coefficient of variation [SMD=-0.01,95%CI（-0.05,0.02）] was not improved significantly（P>0.05）. Conclusion There are no consistent findings regarding whether eHealth interventions can improve immunosuppressive medication adherence in renal transplant recipients across different studies due to various assessment tools. The effects of eHealth interventions on maintaining immunosuppressive blood levels in renal transplant recipients needs to be further confirmed.

Key words: Kidney Transplantation, Immunosuppressive Agents, Medication Adherence, Telemedicine, Electronic health, Systematic review