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Telehealth-delivered, Cardioprotective Diet and Exercise Program for Liver Transplant Recipients: A Randomized Feasibility Study

  • Ingrid J. Hickman*
  • , Amy K. Hannigan
  • , Heidi E. Johnston
  • , Louise Elvin-Walsh
  • , Hannah L. Mayr
  • , Heidi M. Staudacher
  • , Amandine Barnett
  • , Rachel Stoney
  • , Chloe Salisbury
  • , Maree Jarrett
  • , Marina M. Reeves
  • , Jeff S. Coombes
  • , Katrina L. Campbell
  • , Shelley E. Keating
  • , Graeme A. Macdonald
  • *Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Background. Rapid excess weight gain and metabolic complications contribute to poor outcomes following liver transplant care. Providing specialist lifestyle intervention with equitable access is a challenge for posttransplant service delivery. Methods. This study investigated the feasibility of a 12-wk telehealth delivered lifestyle intervention for liver transplant recipients (randomized controlled trial with a delayed intervention control group). The intervention included 14 group sessions facilitated by nutrition and exercise specialists via video streaming telehealth and participants used their own devices. Feasibility was assessed across session attendance, the adequacy, acceptability, and confidence with the telehealth technology and adherence to diet (Mediterranean Diet Adherence Score). Secondary pooled analysis of effectiveness was determined from changes in quality of life and metabolic syndrome severity score. Results. Of the 35 participants randomized, dropout was 22.8% (n = 8) and overall session attendance rate was 60%. Confidence with and adequacy of home technology was rated high in 96% and 91% of sessions, respectively. Participants randomized to the intervention significantly improved Mediterranean Diet Adherence Score (2-point increase [95% confidence interval, 1.5-3.4] versus control 0 point change [95% confidence interval, -1.4 to 1.2]; P = 0.004). Intervention (within group) analysis found the intervention significantly decreased the metabolic syndrome severity score (-0.4 [95% confidence interval, -0.6 to -0.1] P = 0.01), and improved mental health-related quality of life (2.5 [95% confidence interval, 0.4-4.6] P = 0.03). 

Conclusions. A cardioprotective lifestyle intervention delivered via telehealth is feasible for liver transplant recipients and may improve access to specialist care to support metabolic health and wellness after transplant.

Original languageEnglish
Article numbere667
JournalTransplantation Direct
Volume7
Issue number3
Early online date4 Feb 2021
DOIs
Publication statusPublished - Mar 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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  • Research by Master of Nutrition and Dietetic Practice Students

    Isenring, E. (Supervisor), Marshall, S. (Supervisor), Reidlinger, D. (Project Lead), Kelly, J. (Supervisor), Cox, G. (Supervisor), Van der Meij, B. (Supervisor), MacKenzie-Shalders, K. (Supervisor), Mayr, H. (Supervisor), Utter, J. (Associate Professor), Dahl, C. (Masters by Coursework Student), Crichton, M. (Masters by Coursework Student), O'Bryan, K. R. (Masters by Coursework Student), Norris, R. (Masters by Coursework Student), Fahey, M. (Masters by Coursework Student), Davidson, A. (Masters by Coursework Student), Naranjo, A. (Masters by Coursework Student), Mahoney, S. (Masters by Coursework Student), Eberhardt, F. (Masters by Coursework Student), Dalwood, P. (Masters by Coursework Student), Lopez, E. (Masters by Coursework Student), Hofto, S. (Masters by Coursework Student), Innerarity, C. (Masters by Coursework Student), So, D. (Masters by Coursework Student), McIntosh, A. (Masters by Coursework Student), Gadd, N. (Masters by Coursework Student), Chan, H. C. (Masters by Coursework Student), Lan, X. (Masters by Coursework Student), Fei, X. (Masters by Coursework Student), Kostjasyn, S. (Masters by Coursework Student), Adhyaru, P. (Masters by Coursework Student), Giang, J. (Masters by Coursework Student), Leung, E. L. Y. (Masters by Coursework Student), Strike, K. (Project Roles), Pearcy, J. (Masters by Coursework Student), Somani, A. (Masters by Coursework Student), Wright, C. (Masters by Coursework Student), Matthews, C. (Masters by Coursework Student), Lee, G. (Masters by Coursework Student), Tang, X. (Associate Investigator) & Eso, A. (Associate Investigator)

    1/01/1431/12/27

    Project: Research

  • Nutrition for Chronic Disease and Disability: Research to improve health related quality of life and bring forward the under-represented voice

    Reidlinger, D. (Project Lead), Davidson, A. (HDR Student), Campbell, K. (Associate Investigator), Kelly, J. (Associate Investigator), Mayr, H. (Chief Investigator), English, C. (HDR Student), Mueller, K. (Chief Investigator), MacKenzie-Shalders, K. (Assistant Professor), Van der Meij, B. (Research Fellow), Crichton, M. (HDR Student), Marshall, S. (Research Fellow), Turner, C. (Assistant Professor), Marx, W. (Associate Investigator), Utter, J. (Associate Professor), Maugeri, B. (Assistant Professor) & Tang, X. (Admin)

    1/01/1431/08/30

    Project: Research

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