The Effect of Self-Management Education through a Mobile Application on Patient's Self-efficacy and Adherence to Medication after Liver Transplantation (Preprint)

Abstract

One of the causes of liver transplantation failure is a lack of adherence to treatment and medication. Recipients can prevent complications during the treatment to a considerable extent by self-management.

the present study aimed to determine the effect of self-management through a mobile application on patients’ self-efficacy and adherence to medication after liver transplantation.

This study was an educational trial with intervention and control groups and a pre-test/post-test design conducted on 62 liver transplantation patients with the inclusion criteria in Shiraz from 2020 to 2021. The data collection tools included a demographic characteristics questionnaire, the Chronic Disease Self-efficacy scale (CDSES), and the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). First, the CDSES and BAASIS questionnaires were given to the participants of both groups as the pre-test. Afterward, educational information about management and adherence to treatment was provided to the intervention group in the form of a mobile application. The control group received the usual nursing care and education. Three months after the pre-test, the questionnaires mentioned above were completed by the participants for the second time. The data were analyzed using SPSS 25.

The mean scores of self-efficacy and its dimensions before and after the intervention were significantly different in both the control and intervention groups (P-value < 0.05). Moreover, the mean total scores of self-efficacy and its dimensions after the intervention were significantly different between the two groups (P-value < 0.0001). The mean scores of adherence to medications, before and after the intervention, were significantly different between the groups (P-value < 0.05). However, after the intervention, no significant difference was observed between the two groups in terms of adherence to medication (P-value > 0.05).

Teaching self-efficacy through a mobile application and standard education can affect patients' self-efficacy and adherence to treatment after liver transplantation. Therefore, it is recommended that self-efficacy be taught using a mobile application or through traditional methods for patients who are not able to use mobile applications to improve their self-efficacy and adherence to medications and provide services to them.