Medication Adherence Given Individual SystemCHANGE(TM) in Advancing Nephropathy (MAGICIAN) Pilot Study
NCT ID: NCT04616612
Last Updated: 2025-04-23
Study Results
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
COMPLETED
NA
150 participants
INTERVENTIONAL
2021-12-15
2024-02-06
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
SystemCHANGE™ Intervention on Medication Adherence in Older Adults With Heart Failure
NCT03162848
Pharmacists and Pharmacy Technicians to Improve Admission Medication History Accuracy
NCT02026453
Nurse-led Intervention to Improve Phosphate Binder Adherence
NCT02063490
Pharmacist Intervention to Decrease Medication Errors in Heart Disease Patients (The PILL-CVD Study)
NCT00632021
Effect of Pharmacist Initiated Recommendations On Prescribing For Participants In the Senior MEDS Personalized Medication Review
NCT00205140
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
SUPPORTIVE_CARE
SINGLE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
SystemCHANGE (TM)
SystemCHANGE™ focuses on using patients' already established and reliable systems to support medication-taking, rather than focusing on personal effort and "remembering."When applied to medication adherence, the goal is to reduce medication-taking variability and move towards consistently taking medication with a 6-hour window of time (for daily medications like RAAS) and avoid missing medications. SystemCHANGE™ improvement cycles rely on efficient use of performance feedback in order to make decisions about whether system solutions work or if there is a need to select other solutions.
SystemCHANGE (TM)
Participants randomized to the refined SystemCHANGE™ intervention will receive 7 personalized sessions with a nurse-interventionist (session 1 virtual face-to-face, sessions 2-7 via phone) and weekly feedback MMS message reports delivered to mobile phones.
Attention Control
Participants in the attention control will receive educational materials about chronic kidney disease (CKD). The content will be focused on diet, exercise, and living with CKD.
Attention Control
Participants randomized to attention control will receive nurse-led kidney disease self-care education based on materials developed by The National Institute of Diabetes and Digestive and Kidney Diseases and The National Kidney Foundation. Similar to the intervention, participants will receive one virtual visit from the nurse-interventionist and 6 phone calls (weeks 2, 3, 4, 5, 6 and 7) and weekly educational MMS messages delivered by mobile phone.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
SystemCHANGE (TM)
Participants randomized to the refined SystemCHANGE™ intervention will receive 7 personalized sessions with a nurse-interventionist (session 1 virtual face-to-face, sessions 2-7 via phone) and weekly feedback MMS message reports delivered to mobile phones.
Attention Control
Participants randomized to attention control will receive nurse-led kidney disease self-care education based on materials developed by The National Institute of Diabetes and Digestive and Kidney Diseases and The National Kidney Foundation. Similar to the intervention, participants will receive one virtual visit from the nurse-interventionist and 6 phone calls (weeks 2, 3, 4, 5, 6 and 7) and weekly educational MMS messages delivered by mobile phone.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* prescribed at least 1 daily RAAS inhibiting medication
* CKD diagnosis estimated glomerular filtration rate (eGFR) category G1 to G4
* RAAS inhibiting medication adherence of \<.85 documented during the screening phase
* proteinuria defined as a urine Protein-to-Creatinine ratio \> 150 mg/g or urine Albumin-to-Creatinine ratio \>30mg/g
* able to speak, hear, and understand English determined by the ability to participate and comprehend conversation about potential inclusion in the study
* self-reported ability to open a pill cap
* able to self-administer RAAS inhibiting medications
* willing to use a study phone
* has no cognitive impairment as determined by a score of 4 or greater on the 6-item Telephone Mental Status Screen Derived from the Mini-Mental Status Exam (cognitive screener)
* has no other diagnoses that may shorten life span, such as metastatic cancer
* is not currently hospitalized
* receives care through two approved health care systems
Exclusion Criteria
* Participants will be excluded if they are receiving dialysis or have dialysis access placed (e.g. graft or arteriovenous fistula) in anticipation of starting dialysis.
* Kidney and kidney-pancreas transplant recipients will be excluded.
18 Years
99 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
National Institute of Nursing Research (NINR)
NIH
Indiana University
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Rebecca Jane Ellis
Associate Professor
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Rebecca J. Ellis, PhD
Role: PRINCIPAL_INVESTIGATOR
Indiana University School of Medicine
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Indiana University School of Nursing
Indianapolis, Indiana, United States
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Tangkiatkumjai M, Walker DM, Praditpornsilpa K, Boardman H. Association between medication adherence and clinical outcomes in patients with chronic kidney disease: a prospective cohort study. Clin Exp Nephrol. 2017 Jun;21(3):504-512. doi: 10.1007/s10157-016-1312-6. Epub 2016 Jul 20.
Muntner P, Judd SE, Krousel-Wood M, McClellan WM, Safford MM. Low medication adherence and hypertension control among adults with CKD: data from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2010 Sep;56(3):447-57. doi: 10.1053/j.ajkd.2010.02.348. Epub 2010 May 14.
Cedillo-Couvert EA, Ricardo AC, Chen J, Cohan J, Fischer MJ, Krousel-Wood M, Kusek JW, Lederer S, Lustigova E, Ojo A, Porter AC, Sharp LK, Sondheimer J, Diamantidis C, Wang X, Roy J, Lash JP; CRIC Study Investigators. Self-reported Medication Adherence and CKD Progression. Kidney Int Rep. 2018 Feb 2;3(3):645-651. doi: 10.1016/j.ekir.2018.01.007. eCollection 2018 May.
Williams A, Manias E, Walker R, Gorelik A. A multifactorial intervention to improve blood pressure control in co-existing diabetes and kidney disease: a feasibility randomized controlled trial. J Adv Nurs. 2012 Nov;68(11):2515-25. doi: 10.1111/j.1365-2648.2012.05950.x. Epub 2012 Feb 15.
Ong SW, Jassal SV, Miller JA, Porter EC, Cafazzo JA, Seto E, Thorpe KE, Logan AG. Integrating a Smartphone-Based Self-Management System into Usual Care of Advanced CKD. Clin J Am Soc Nephrol. 2016 Jun 6;11(6):1054-1062. doi: 10.2215/CJN.10681015. Epub 2016 May 12.
Conn VS, Ruppar TM, Enriquez M, Cooper P. Medication adherence interventions that target subjects with adherence problems: Systematic review and meta-analysis. Res Social Adm Pharm. 2016 Mar-Apr;12(2):218-46. doi: 10.1016/j.sapharm.2015.06.001. Epub 2015 Jun 15.
Easthall C, Song F, Bhattacharya D. A meta-analysis of cognitive-based behaviour change techniques as interventions to improve medication adherence. BMJ Open. 2013 Aug 9;3(8):e002749. doi: 10.1136/bmjopen-2013-002749.
Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD000011. doi: 10.1002/14651858.CD000011.pub3.
Ivers NM, Grimshaw JM, Jamtvedt G, Flottorp S, O'Brien MA, French SD, Young J, Odgaard-Jensen J. Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care. J Gen Intern Med. 2014 Nov;29(11):1534-41. doi: 10.1007/s11606-014-2913-y.
Rambod M, Heine GH, Seiler S, Dominic EA, Rogacev KS, Dwivedi R, Ramezani A, Wing MR, Amdur RL, Fliser D, Raj DS. Association of vascular endothelial factors with cardiovascular outcome and mortality in chronic kidney disease patients: a 4-year cohort study. Atherosclerosis. 2014 Oct;236(2):360-5. doi: 10.1016/j.atherosclerosis.2014.07.026. Epub 2014 Aug 12.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004 Sep 23;351(13):1296-305. doi: 10.1056/NEJMoa041031.
Debella YT, Giduma HD, Light RP, Agarwal R. Chronic kidney disease as a coronary disease equivalent--a comparison with diabetes over a decade. Clin J Am Soc Nephrol. 2011 Jun;6(6):1385-92. doi: 10.2215/CJN.10271110. Epub 2011 Mar 10.
Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, de Zeeuw D, Shahinfar S, Toto R, Levey AS; AIPRD Study Group. Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: a patient-level meta-analysis. Ann Intern Med. 2003 Aug 19;139(4):244-52. doi: 10.7326/0003-4819-139-4-200308190-00006.
Evans M, Bain SC, Hogan S, Bilous RW; Collaborative Study Group participants. Irbesartan delays progression of nephropathy as measured by estimated glomerular filtration rate: post hoc analysis of the Irbesartan Diabetic Nephropathy Trial. Nephrol Dial Transplant. 2012 Jun;27(6):2255-63. doi: 10.1093/ndt/gfr696. Epub 2011 Dec 15.
Xie X, Atkins E, Lv J, Bennett A, Neal B, Ninomiya T, Woodward M, MacMahon S, Turnbull F, Hillis GS, Chalmers J, Mant J, Salam A, Rahimi K, Perkovic V, Rodgers A. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016 Jan 30;387(10017):435-43. doi: 10.1016/S0140-6736(15)00805-3. Epub 2015 Nov 7.
Chowdhury R, Khan H, Heydon E, Shroufi A, Fahimi S, Moore C, Stricker B, Mendis S, Hofman A, Mant J, Franco OH. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013 Oct;34(38):2940-8. doi: 10.1093/eurheartj/eht295. Epub 2013 Aug 1.
Roy L, White-Guay B, Dorais M, Dragomir A, Lessard M, Perreault S. Adherence to antihypertensive agents improves risk reduction of end-stage renal disease. Kidney Int. 2013 Sep;84(3):570-7. doi: 10.1038/ki.2013.103. Epub 2013 May 22.
Magacho EJ, Ribeiro LC, Chaoubah A, Bastos MG. Adherence to drug therapy in kidney disease. Braz J Med Biol Res. 2011 Mar;44(3):258-62. doi: 10.1590/s0100-879x2011007500013. Epub 2011 Feb 4.
Karamanidou C, Clatworthy J, Weinman J, Horne R. A systematic review of the prevalence and determinants of nonadherence to phosphate binding medication in patients with end-stage renal disease. BMC Nephrol. 2008 Jan 31;9:2. doi: 10.1186/1471-2369-9-2.
Chang TI, Gao L, Brown TM, Safford MM, Judd SE, McClellan WM, Limdi NA, Muntner P, Winkelmayer WC. Use of secondary prevention medications among adults with reduced kidney function. Clin J Am Soc Nephrol. 2012 Apr;7(4):604-11. doi: 10.2215/CJN.11441111. Epub 2012 Feb 16.
Schmitt KE, Edie CF, Laflam P, Simbartl LA, Thakar CV. Adherence to antihypertensive agents and blood pressure control in chronic kidney disease. Am J Nephrol. 2010;32(6):541-8. doi: 10.1159/000321688. Epub 2010 Nov 2.
Marcum ZA, Sevick MA, Handler SM. Medication nonadherence: a diagnosable and treatable medical condition. JAMA. 2013 May 22;309(20):2105-6. doi: 10.1001/jama.2013.4638. No abstract available.
Crowley MJ, Bosworth HB, Coffman CJ, Lindquist JH, Neary AM, Harris AC, Datta SK, Granger BB, Pereira K, Dolor RJ, Edelman D. Tailored Case Management for Diabetes and Hypertension (TEACH-DM) in a community population: study design and baseline sample characteristics. Contemp Clin Trials. 2013 Sep;36(1):298-306. doi: 10.1016/j.cct.2013.07.010. Epub 2013 Aug 2.
Shrestha SS, Shakya R, Karmacharya BM, Thapa P. Medication adherence to oral hypoglycemic agents among type II diabetic patients and their clinical outcomes with special reference to fasting blood glucose and glycosylated hemoglobin levels. Kathmandu Univ Med J (KUMJ). 2013 Jul-Sep;11(43):226-32. doi: 10.3126/kumj.v11i3.12510.
Nieuwlaat R, Wilczynski N, Navarro T, Hobson N, Jeffery R, Keepanasseril A, Agoritsas T, Mistry N, Iorio A, Jack S, Sivaramalingam B, Iserman E, Mustafa RA, Jedraszewski D, Cotoi C, Haynes RB. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2014 Nov 20;2014(11):CD000011. doi: 10.1002/14651858.CD000011.pub4.
Moore SM, Jones L, Alemi F. Family self-tailoring: Applying a systems approach to improving family healthy living behaviors. Nurs Outlook. 2016 Jul-Aug;64(4):306-311. doi: 10.1016/j.outlook.2016.05.006. Epub 2016 May 18.
Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. Available from http://www.ncbi.nlm.nih.gov/books/NBK225182/
Russell CL. A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement. Clin Nurse Spec. 2010 Mar-Apr;24(2):69-75. doi: 10.1097/NUR.0b013e3181cf554d.
Russell CL, Ruppar TM, Matteson M. Improving medication adherence: moving from intention and motivation to a personal systems approach. Nurs Clin North Am. 2011 Sep;46(3):271-81, v. doi: 10.1016/j.cnur.2011.05.004.
Alemi F, Neuhauswer D. A thinking person's step by step guide to changing your lifestyle: Weight loss and exercise program. . Victoria, Canada: Trafford Publishing. 2005.
Richard AA, Shea K. Delineation of self-care and associated concepts. J Nurs Scholarsh. 2011 Sep;43(3):255-64. doi: 10.1111/j.1547-5069.2011.01404.x. Epub 2011 Jul 25.
Bronfenbrenner U. Toward an experimental ecology of human development. American psychologist. 1977;32(7):513.
Williams A, Manias E, Liew D, Gock H, Gorelik A. Working with CALD groups: testing the feasibility of an intervention to improve medication self- management in people with kidney disease, diabetes, and cardiovascular disease. Renal Society of Australasia
Russell CL, Hathaway D, Remy LM, Aholt D, Clark D, Miller C, Ashbaugh C, Wakefield M, Ye S, Staggs VS, Ellis RJ, Goggin K. Improving medication adherence and outcomes in adult kidney transplant patients using a personal systems approach: SystemCHANGE results of the MAGIC randomized clinical trial. Am J Transplant. 2020 Jan;20(1):125-136. doi: 10.1111/ajt.15528. Epub 2019 Aug 20.
Russell C, Conn V, Ashbaugh C, Madsen R, Wakefield M, Webb A, Coffey D, Peace L. Taking immunosuppressive medications effectively (TIMELink): a pilot randomized controlled trial in adult kidney transplant recipients. Clin Transplant. 2011 Nov-Dec;25(6):864-70. doi: 10.1111/j.1399-0012.2010.01358.x. Epub 2010 Nov 16.
Matteson M, Russell C, Winn J. Pilot Intervention to Improve Medication Adherence in Nonadherent Inflammatory Bowel Disease Patients: P-3. Inflammatory Bowel Diseases. 2011;17(Suppl_2):S13-S13.
Welch JL, Bartlett Ellis RJ, Perkins SM, Johnson CS, Zimmerman LM, Russell CL, Richards C, Guise DM, Decker BS. Knowledge and Awareness Among Patients with Chronic Kidney Disease Stage 3. Nephrol Nurs J. 2016 Nov-Dec;43(6):513-519.
Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health. 2008 Apr;31(2):180-91. doi: 10.1002/nur.20247.
Russell CL, Conn VS, Ashbaugh C, Madsen R, Hayes K, Ross G. Medication adherence patterns in adult renal transplant recipients. Res Nurs Health. 2006 Dec;29(6):521-32. doi: 10.1002/nur.20149.
Radhakrishnan K. The efficacy of tailored interventions for self-management outcomes of type 2 diabetes, hypertension or heart disease: a systematic review. J Adv Nurs. 2012 Mar;68(3):496-510. doi: 10.1111/j.1365-2648.2011.05860.x. Epub 2011 Oct 20.
Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PLoS One. 2014 Feb 5;9(2):e88166. doi: 10.1371/journal.pone.0088166. eCollection 2014.
Horvath T, Azman H, Kennedy GE, Rutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. Cochrane Database Syst Rev. 2012 Mar 14;2012(3):CD009756. doi: 10.1002/14651858.CD009756.
Shimohata H, Maruyama H, Ogawa Y, Kobayashi M. Hyperthyroidism associated with obesity-related glomerulopathy-like pathologic features. Intern Med. 2014;53(9):997-9. doi: 10.2169/internalmedicine.53.1814. Epub 2014 May 1.
Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care. 2002 Sep;40(9):771-81. doi: 10.1097/00005650-200209000-00007.
Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86. doi: 10.1016/s0005-7916(00)00012-4.
Denhaerynck K, Schafer-Keller P, Young J, Steiger J, Bock A, De Geest S. Examining assumptions regarding valid electronic monitoring of medication therapy: development of a validation framework and its application on a European sample of kidney transplant patients. BMC Med Res Methodol. 2008 Feb 19;8:5. doi: 10.1186/1471-2288-8-5.
Bowling A. Just one question: If one question works, why ask several? J Epidemiol Community Health. 2005 May;59(5):342-5. doi: 10.1136/jech.2004.021204. No abstract available.
Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, Ogedegbe G, Orwig D, Ernst D, Czajkowski S; Treatment Fidelity Workgroup of the NIH Behavior Change Consortium. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004 Sep;23(5):443-51. doi: 10.1037/0278-6133.23.5.443.
Bronfenbrenner U. The ecology of human development: Experiments by design and nature. In: Cambridge, MA: Harvard University Press; 1979.
Deming E., Orsini J. The Essential Deming: Leadership Principles from the Father of Quality. New York, NY: McGraw-Hill Education; 2012.
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Document Type: Informed Consent Form
Study Documents
Access uploaded study-related documents such as protocols, statistical analysis plans, or lay summaries.
Document Type: Clinical Study Report
United States Renal Data System. USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD. 2017.
View DocumentDocument Type: Statistics
US Department of Health \& Human Services. Kidney disease statistics for the United States. Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse, National Institutes of Health. 2011.
View DocumentDocument Type: Clinical Study Report
KDIGO. Kidney Disease: Improving global outcomes blood pressure work group, KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney International. 2012;Suppl. 2(5):337-414.
View DocumentDocument Type: Clinical Study Report
National Institute of Diabetes and Digestive and Kidney Diseases. High Blood Pressure and Kidney Disease. In. NIH Publication No. 14-4572 ed. Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC); 2014:12.
View DocumentDocument Type: Pamphlet
U.S. Department of Health and Human Services. National Institutes of Health. In Brief: Your Guide to Healthy Sleep. In. Vol NIH Publication No. 11-5800. Bethesda, MA: NHLBI Health Information Center; 2011:1-4.
View DocumentDocument Type: Education
National Kidney Foundation. Nutrition and Chronic Kidney Disease (Stages 1-4). Are You Getting What You Need? In. Vol 11-10-1811\_HBE. 11-10-1811\_HBE ed. New York, NY: National Kidney Foundation; 2013-2014:1-28.
View DocumentDocument Type: Education
National Kidney Foundation. Hidden health risks: Kidney Disease, Diabetes, and High Blood Pressure. In. Vol 11-10-1811\_HBE. New York, NY: National Kidney Foundation 2014:1-20.
View DocumentOther Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2001957718
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.