Acceptability and preferences for a smartphone intervention among liver transplant recipients: Prototype for the liveright transplant app

ABSTRACT

Background: Smartphone applications are on the rise;yet it is unclear whether liver transplant (LT) recipients would use or benefit from this technology. We aimed to understand baseline smartphone practices and identify preferences for an app-based intervention to guide the development of the LiveRightTM Transplant app among LT recipients Methods: Twenty in-depth, in-person interviews were conducted from 2019-2020 among adults 3 to 6 months after LT at the University of North Carolina We evaluated baseline use of smartphone technology, as well as acceptability of and preferences for a LT app Interviews were conducted by trained qualitative experts and analyzed in an iterative fashion using a thematic content approach to identify relevant themes Coded transcripts were analyzed using Dedoose qualitative software Results: Among 20 LT recipients, median age was 61 years (range 28-68);65% were male;60% Caucasian;40% underwent LT for non-alcoholic fatty liver disease, 20% for viral hepatitis, and 10% for alcohol-associated liver disease Patients lived 76 miles (range 14-270) from the hospital A majority (90%) of patients owned smartphones In addition to calls, text, and email, smartphone users engaged in social media including Facebook (55%), sought information through search engines (50%), and played games or watched videos (30%) on their phones Most (65%) used EPIC MyChart to communicate with the transplant team and set phone alarms for medication reminders A majority (80%) were interested in a LT app that enabled 1) anonymous and secure ways to connect with other LT recipients, 2) logging biometric data, 3) medication reminders including real time updates of dosages, 4) virtual communication with the medical team (after hours or early in post-LT recovery when difficult to travel to clinic), and 5) vetted educational materials especially on medication side effects/symptoms, diet, and physical activity (Figure 1) Conclusion: LT recipients want a smartphone app to aid in their recovery Most important to them is connecting with other LT recipients for peer support, educational resources related to expectations, symptoms and medication side effects, and easy options to log biometric data to be shared with their transplant team With the advent of COVID-19, using smartphone interventions will be critical to improving transplant outcomes These data informed the development of the LiveRightTM app with pilot testing underway. (Table Presented).