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TEST Trial


Technology Enabled Strategies to Promote Treatment Adherence in Liver Transplant: The TEST Trial 


December 2022 – November 2026 

Funding Source:

National Institute of Diabetes and Digestive and Kidney Diseases 

Grant Number:



Liver transplantation (LT), the only lifesaving treatment for end-stage liver disease, is increasingly performed for older adults with multiple comorbidities. Medication adherence is key to maintaining proper function of the transplanted liver and optimize overall health; however, adhering to post-transplant treatment regimens is a very complex process. This clinical trial will study how readily available technology-enabled tools combined with transplant center resources and care partner support can optimize medication adherence, quality of life, and health outcomes among new liver transplant recipients (LTRs) at 3 diverse centers.


The Technology Enabled Strategies to promote Treatment adherence in Liver Transplant: TEST intervention is an evidence-based and patient-centered strategy to optimize the delivery of clinical care after LT. Guided by our conceptual framework, we leverage widely available technologies (electronic health record (EHR), mobile devices) in a ‘low touch’ manner to support and track regimen use and activate appropriate transplant center clinical staff (nurse coordinator, pharmacist, social worker, advanced practice provider/physician) when specific problems are identified. The goal is to optimize regimen adherence to improve health outcomes in transplant and for comorbid conditions. The intervention is transplant-center-based given pre-existing resources and is one of the first in LT to leverage care partner support.  
The Specific Aims are: 
Aim 1: Investigate the effectiveness of the TEST strategy to improve adherence to immunosuppression and non- immunosuppression medication regimens, functional health status, and health outcomes compared to usual care.  
Aim 2: Determine the fidelity of each component of the intervention over time and identify patient, care partner, provider, or transplant center factors associated with optimal implementation.  
Aim 3: Assess the cost effectiveness of TEST from a transplant center and healthcare sector perspectives. identifier:



• Principal Investigators: Julia Yoshino Benavente, MPH
• Project Lead: Allison Novorita