Leveraging Technology to Improve Medication Adherence in Youth With Kidney or Liver Transplant

Can the investigators create an effective way to improve adherence to immunosuppressant medication and reduce rejection, graft loss, and death in adolescents and young adults who have undergone kidney or liver transplantation? The investigators' mobile technology intervention uses real-time electronic pillbox-assessed dose timing and text message prompts to address antirejection medication nonadherence when nonadherence is detected.

Inclusion Criteria:Adolescents and young adults (13-25 years old) who underwent kidney or liver transplantation at least 6 months prior to enrollmentCurrently prescribed tacrolimus or sirolimus.Exclusion Criteria:Currently receiving dialysisHospitalized for duration of studySignificant developmental or cognitive delayNo access to a mobile device that supports text messagingDecline to use electronic pill box to monitor daily medication adherenceNon-English speakingIf a participant meets inclusion criteria, enrolls in the study, and experiences graft failure potentially leading to dialysis in the case of kidney transplant recipients, the participant will be given the option to continue in the study if they remain on tacrolimus or sirolimus.