Abstract
PURPOSE: To evaluate the application effect of remote interventions based on digital health technology in kidney transplant patients through a systematic review. DESIGN: Systematic review. METHODS: The databases of PubMed, Embase, Cochrane Library, CINAHL, and Web of Science were systematically searched for randomized controlled trials and quasi - experimental studies on remote interventions based on digital health technology in kidney transplant recipients. The search time limit ranged from the establishment of the databases to September 2024. RESULTS: A total of 10 articles were included, involving 535 patients. A total of 21 clinical outcomes were identified in this study and they were classified into three categories, namely: ① Health-related conditions: Number of steps (n = 1), heart rate (n = 1), self-burden score (n = 1), self-management ability (n = 1), quality of life score (n = 2), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) (n = 1), psychological distress (n = 1). ② Medication adherence and average tacrolimus concentration: Medication adherence (n = 5), number of missed doses (n = 1), medication errors (n = 1), rejection reactions (n = 1), average creatinine level (n = 1), tacrolimus blood concentration level (n = 2), within-patient variability of tacrolimus (n = 1), coefficient of variation (CV) of tacrolimus (n = 1). ③ Medical economic status: Nursing satisfaction (n = 1), incidence of adverse events (n = 1), rate of unplanned hospitalization (n = 3), duration of unplanned hospitalization (n = 1), one-year medical cost (n = 2), nursing cost (n = 1). CONCLUSION: Remote interventions based on digital health technology can improve the health - related conditions, medication adherence and medical economic status of kidney transplant recipients. However, its impact on tacrolimus concentration remains unclear. Clinical medical staff should fully recognize its positive effects.