TABLE 2.

Studies focused on attitude of kidney transplant recipients toward telemedicine and barriers, in chronological order

Author	Year	No. of patients	Design/objective	Results	Concerns
McGillicuddy et al10	2013	99	Patients attitude toward mobile phone–based remote monitoring and management of their medical regimen	79% (78/99) reported a positive attitude toward the use of the system Offers improved self-efficacy and improved medical management	Only 7% knew of the opportunity to use a mobile device for monitoring their medications 35% owned a smartphone Costs Technological adeptness
Browning et al12	2016	139	Cross-sectional study (questionnaire) to assess smartphone ownership, use of mHealth apps, and willingness to use it	61% owned a smartphone, 30% had prior knowledge of mHealth, and 7% were already using a mHealth app; 78% reported a positive attitude Younger patients (<55 y) were more likely to own a smartphone (75% vs 46%) and more frequently agree with use of mHealth (62% vs 36%)	Selection bias by recipients attending outpatient clinic
Reber et al75	2018	109	Cross-sectional study on the mobile technology affinity of kidney transplant recipients	57% used a smartphone or tablet and 45% used apps Younger and higher educated patients had significantly higher scores in mobile technology affinity	No data on internet use or reason for nonusage of smartphone/tablets/apps No data on attitude toward medication adherence app
Vanhoof et al76	2018	122 (30 kidney)	Cross-sectional, descriptive study in adult heart, lung, liver, and kidney transplant recipients to understand recipients’ overall willingness to use telemedicine for self-management support and investigate associations with relevant technology acceptance variables, and explore recipients’ views on telemedicine	Recipients rated importance of telemedicine for self-management on average as 7 on a 10-point numeric scale; higher educated patients, and users of telecommunication technology gave higher scores compared with lower educated or telecommunication nonusers Recipients preferred automatic data transfer, visual aids over text messages, and personal influence in access to telemedicine	Only 28% owned a smart phone (study performed in 2013) Most recipients were not eager to receive messages or reminders Selection bias by exclusion nonnative (Dutch) speakers
O’Brien et al77	2019	165	Cross-sectional study (questionnaire) to explore characteristics of users, use, barriers, and perceptions of mobile apps for self-management	Knowledge was greatest barrier reported by non–app users. Significantly fewer hospitalizations in mHealth app users versus other apps or nonusers (adjusted for patient demographics)	Selection bias by patients attending outpatient clinic Cross-sectional nature lacking causal relationship with hospitalizations
Nielsen et al50	2020	16	Explorative qualitative study on patients’ experiences of using a telehealth solution developed to improve follow-up after kidney transplantation	Transplant recipients found the app easy to use, and it facilitated support and management of problems. It improved preparation for consultation, improved dialogue, and enabled teleconsultation	Two training sessions were provided, possibly boosting adherence and usage of app 16 of 28 patients completed the test period No video consultations were possible but were desirable
Huuskes et al78	2021	34	Focus groups comprised 10 participants from kidney transplants recipients who joined via Zoom to have discussions on patient perspectives on telehealth during the COVID-19 pandemic	Different themes recognized, including minimizing burden (convenience and ease, efficiency of appointments, reducing exposure to risk, limiting work disruptions, and alleviating financial burden); attuning to individual context (respecting patient choice of care and ensuring a conducive environment); and empowerment and readiness (increased responsibility for self-management, confidence in physical assessment, mental preparedness, and forced independence)	Personal connection and trust needs protection. Hampering honest conversations, Less reassurance of follow-up and missed opportunity to share live experience Technical challenges and patient digital literacy

COVID-19, coronavirus disease 2019.