The design of an Internet-based system to maintain home monitoring adherence by lung transplant recipients

Regimen adherence is a key factor in the success of home monitoring of lung transplant recipients. Patients generally adhere satisfactorily with home spirometry in the short-term, but adherence tends to decline over time. Telehealth and Internet technology provide new methods to address this issue. The unique contribution of the Adherence Enhancement Internet Program (AEIP) is the integration of multiple adherence enhancement strategies operating in a unified approach to the adherence problem, while meshing all user groups to facilitate interactions. This Internet-based program focused on promoting subject specific strategies was developed to maintain the initial high levels of adherence beyond the first year post transplant. The program provides more immediate subject feedback related to home monitoring data, reminders from the patient's health care providers, educational material, and guidance in dealing with subject specific barriers to maintaining adherence. It also simplifies communication between patients and health care providers, and supports providers in certain patient care tasks. A feasibility trial involving 12 lung transplant recipients demonstrated that subjects were able to use the AEIP with little training, found it acceptable, and were generally enthusiastic regarding it as a tool to maintain or enhance adherence.