Self-monitoring creatinine after transplantation: the (un)reliability of patient reported data.

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C.L. van Lint, W. Wang, S. Van Dijk, W.P Brinkman, T. Rövekamp, M. Neerincx, A.J. Rabelink, P.J.M van der Boog

Chair(s): dr. M.H.L. Christiaans & dr. R.J. Toorop

Thursday 9 march 2017

8:24 - 8:36h at Johan de Meesterzaal

Categories: Parallel - Klinisch

Parallel session: Parallelsessie XI – Klinisch 3 - Early Bird sessie 2

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Background:
Self-monitoring creatinine is a promising new health care strategy to reduce number of outpatient visits after kidney transplantation. The current study used data from a self-management intervention to investigate whether it is safe to rely on patients’ reported self-measurements.

Methods:
During the first year post-transplantation 54 patients registered their self-measured creatinine values in an online Self-Management Support System (SMSS) which provided automatic feedback on the registered values (e.g. contact hospital). Values registered in the SMSS were compared to those logged in the creatinine device to study reliability of registered data. Adherence to measurement frequency was determined by comparing number of requested with number of performed measurements. To study adherence to provided feedback, SMSS logged feedback and information from the electronic hospital files were analysed.

Results:
Eighty-seven percent of all registered creatinine values was entered correctly, although values were often registered several days later. In case of a difference between (number of) measured and registered values,  registered creatinine values were significantly lower than the measured ones, suggesting active selection of lower creatinine values. Level of adherence to measurement protocol was highest during month 2-4 post-transplantation with over 90% of patients performing at least 75% of the requested measurements. Adherence to SMSS feedback ranged from 53-85% depending on the specific feedback.

Discussion:
Patients’ tendency to select lower creatinine values for registration and to postpone registration and the suboptimal adherence to the SMSS provided feedback might challenge the safety of self-monitoring. These issues can mostly be overcome by transferring measured data automatically.