Please select the eligibility criteria that correspond to the clinical trial below.
Title: Compliance/Adherence After Kidney Transplant, With or With Out an Electronic Drug Dispenser(Med-O-Wheel™), Karolinska University Hospital.
Brief Summary: Background:

Adherence to the immunosuppressive drug regimen is critical to the outcome after an organ transplant. Patients need to take their prescribed medications and attend their appointments with the doctor.

Based on previous studies in other European countries, the cost of non-compliance after organ transplantation in Sweden is \>SEK 35 million/year.

Patients who lose their graft both lose quality of life and have decreased expected survival; moreover, retransplantation may be hampered by new HLA antibodies.

Question:

The primary question is whether Med-O-Wheel™ can improve compliance to the prescribed medication regimen in renal transplant patients.

Methods and materials:

All kidney transplant patients at Karolinska University Hospital, Huddinge, will be given information about the study and will then be asked to participate. Participants will be randomized into two arms, one arm with and one with out Med-O-Wheel™. The 80 included patients will be closely monitored for 1 year regarding intake of prescribed medications.

Med-O-Wheel™ is an electronic medication dispenser that records the date and time of each occasion when the patient takes medications from the dispenser. It has a SIM card and text messaging capabilities.

Addoz Portal™ is a web-based application that makes it possible to monitor and analyse medication intake. Each event in the medication dispenser is registered in the portal, which communicates with the care provider/support person by text message, e-mail or telephone.

Significance of the study:

In the future it may be possible to improve compliance in transplant patients. In particular, patients will feel secure since they will receive confirmation through the portal that they are taking their medications safely and accurately.


Options:
A: Subject is eligible for the study if the following apply:

* Receiving a kidney transplant from a deceased or living donor in Karolinska University Hospital
* Capable of understanding the purpose of the study, fully informed and having written informed consent (signed Informed Consent has been obtained)

No study-specific exclusion criteria
B: Inclusion Criteria:

- current prescription of tacrolimus less than 98% adherence to medication prescription as determined by three baseline pill counts

Exclusion Criteria:

- lack of telephone to complete pill counts lack of English proficiency to participate in adherence promotion sessions
C: Inclusion Criteria:

* received a kidney or a kidney-pancreas transplant in the University Hospital Zürich

Exclusion Criteria:

* unstable psychiatric disorder
* cognitive impairment
* multi-organ transplantation with lung
* liver or heart
* illiteracy
* not able to speak and understand German
D: Inclusion Criteria:

* a recipient of a lung transplant
* 18 years of age or older
* stable enough to be transferred from the CTICU to the acute unit
* not been discharged from initial transplant hospitalization
* able to read and speak English

Exclusion Criteria:

* a recipient of any prior transplant
* a condition that precludes discharge from the hospital
* limited involvement in post-transplant care is anticipated (e.g., plan to discharge to skilled nursing facility)

Answer: A