{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:59Z","timestamp":1760142539590,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Medication adherence and timing of doses remains a challenge for adolescent patients following heart transplant. Mobile technology and adherence promotion efforts offer new avenues for direct observation of medication adherence and timeliness of medication\u2010taking behavior. The study explores posttransplant medication maintenance, highlighting the importance of consistent dose timing with tacrolimus. The use of directly observed therapy (DOT) via a mobile health app was examined as a method for real\u2010time medication monitoring, offered a platform for patients to upload videos of themselves taking medication for review by transplant team members.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study examined a single\u2010group design involving 10 adolescent heart transplant recipients over a 12\u2010week DOT intervention, assessing both medication adherence and post\u2010intervention outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results from multilevel regression models analyzing inter\u2010dose timing and deviation from 12\u2010h intervals revealed significant variability among patients and a correlation between increased deviation from the 12\u2010h dose interval and both older patients and those with greater perceived barriers to medication adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings suggested a link between deviation from recommended dose timing and poorer posttransplant health outcomes. Findings underscored the potential of DOT and mobile health to examine timeliness of medication adherence, to directly observe medication\u2010taking behavior, and association with posttransplant health outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14851","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T22:12:29Z","timestamp":1743199949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inter\u2010Dose Variability of Immunosuppressant Medication Among Adolescent Heart Transplants During Video Directly Observed Therapy"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2287-9007","authenticated-orcid":false,"given":"Michael O.","family":"Killian","sequence":"first","affiliation":[{"name":"College of Social Work Florida State University  Tallahassee Florida USA"},{"name":"College of Medicine Florida State University  Tallahassee Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-5193","authenticated-orcid":false,"given":"Sonnie E.","family":"Mayewski","sequence":"additional","affiliation":[{"name":"College of Social Work Florida State University  Tallahassee Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2261-3278","authenticated-orcid":false,"given":"Schyler E.","family":"Brumm","sequence":"additional","affiliation":[{"name":"College of Social Work Florida State University  Tallahassee Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wally","family":"Wissner","sequence":"additional","affiliation":[{"name":"Scene Health Inc.  Brooklandville Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2193-493X","authenticated-orcid":false,"suffix":"IV","given":"Richard W.","family":"Davis","sequence":"additional","affiliation":[{"name":"Independent Scholar  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0143-7143","authenticated-orcid":false,"given":"Dipankar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Congenital Heart Center, UF Health Shands Children's Hospital University of Florida  Gainesville Florida USA"},{"name":"Department of Pediatrics, College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2005.00356.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/11317240-000000000-00000"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2716"},{"key":"e_1_2_10_5_1","unstructured":"\u201cPrograf (tacrolimus) [Summary of Product Characteristics] \u201d(2006)."},{"key":"e_1_2_10_6_1","unstructured":"U.S Food and Drug Administration \u201cInc. 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