Please select the eligibility criteria that correspond to the clinical trial below.
Title: Behavioral Contract Intervention to Improve Adherence Among Renal Transplant Recipients
Brief Summary: There is a critical gap in the knowledge on how to implement effective interventions for renal transplant recipients (RTRs) to improve immunosuppressant therapy (IST) adherence and clinical outcomes. The objectives of this project were to address this gap through: (1) designing, implementing, and evaluating a patient-specific behavioral contract intervention to improve RTRs' IST adherence rates (contracts are written, signed agreements between the RTR and healthcare provider in which the RTR agrees to be adherent to IST according to mutually agreed upon criteria); and (2) measuring the effects of IST adherence on RTRs' health-related quality of life (HQoL) and healthcare utilizations and costs. The primary hypothesis was that at one year post trial enrollment, RTRs who establish behavioral contracts with healthcare professionals will be more adherent than those who do not establish behavioral contracts and subsequently will have greater HQoL and lower healthcare utilizations and costs. Once it is better understood how to implement effective IST adherence intervention programs, clinicians will have a valuable tool to promote therapeutic success, improve HQoL, and reduce healthcare utilizations and costs. Therefore, we pursued the following Specific Aims: (1) determine the effectiveness of an IST adherence contract-based intervention on IST adherence; (2) determine the relationship between IST adherence, the intervention, and RTRs' HQoL; and (3) determine the influence of IST adherence and the intervention on RTRs' healthcare utilizations/costs. To achieve the Specific Aims, a randomized controlled trial of the patient-specific behavioral contract-based intervention was conducted, and data regarding adherence, HQoL, and healthcare utilizations/costs were collected over a 12-month period for each RTR study participant and analyzed. This project will promote healthy lives, increase well-being, and reduce burden of illness and disparity among adult RTRs by providing data regarding an adherence intervention and the impact of IST adherence and the behavioral contract intervention on RTRs' health and economic outcomes and HQoL. Collectively, this new knowledge will provide critical steps toward optimizing RTRs' graft maintenance, productivity, and HQoL, while decreasing graft rejection, return to dialysis, morbidity, mortality, and healthcare costs.


Options:
A: Inclusion Criteria:

* Self-identify as Black, White, or Hispanic
* Must not have been deemed kidney transplant ineligible by UCLA Kidney and Pancreas Transplant Program
* Cannot be listed at another transplant center
* Can read English

Exclusion Criteria:

* Does not self-identify as Black, White, or Hispanic
* Deemed ineligible to receive a kidney transplant by UCLA Kidney and Transplant Program
* Listed at another transplant center
* Cannot read English
B: Inclusion Criteria:

* People with a history of solid organ transplantation within the last 2 years
* Speaks English
* Can see to do SSE, capable of seeing to read a newspaper
* Stable health, patients report a general state of well being

Exclusion Criteria:

* Unable to speak English
* Insufficient vision to see their own skin as determined by their ability to read a newspaper
* Comorbid debilitating disease
* Dementia or insufficient cognitive skills to follow instructions provided at a sixth grade language level.
C: Inclusion Criteria:

* renal transplant recipient
* at least 21 years of age
* receive an immunosuppressant regimen that contains oral cyclosporine or tacrolimus
* be at least one year post-transplant
* obtain immunosuppressant therapy from Avella Specialty Pharmacy for at least one year prior to study enrollment and during the study period

Exclusion Criteria:

* pregnant
* prisoner
* institutionalized
* unable to give informed consent
D: Inclusion Criteria:

* Patients diagnosed with end-stage kidney disease (ESKD) and established on hemodialysis with the National Kidney Foundation Singapore (NKF) for fewer than 90 days
* At least 21 years old
* Proficient in spoken and written English or Mandarin

Exclusion Criteria:

* Unwilling or unable to give informed consent or refuse to be randomized
* Have cognitive impairments or psychiatric conditions that preclude consent
* Are currently involved in other intervention trials
* Are failing on dialysis and approaching end of life (supportive/palliative care pathway)

Answer: C