Telemonitoring post-renal transplantation and role of advanced practice nurses: a single center experience

Introduction: Telemonitoring has the potential to improve access to care and continuity of follow-up after kidney transplantation. Advanced practice nurses (APNs) play an increasingly important role in coordinating remote care pathways. This study evaluated patient experience with telemonitoring after renal transplantation, identified determinants of adherence, and clarified the role of APNs in this model. Methods: We conducted a single-center retrospective observational study including adult kidney transplant recipients enrolled in a telemonitoring program between April 2020 and April 2022. Patients were classified as active users (TOUCO), discontinued users (STOPCO), or never users (JAMCO). Satisfaction and experience were assessed through questionnaires. Platform activity and APN workload were analyzed using descriptive statistics. Results: Among 207 eligible patients, 110 responded to the survey (53%): 64 TOUCO (71%), 11 STOPCO (47%), and 35 JAMCO (37%). Active users reported high satisfaction with response time (89%), improved access to care (81%), and increased reassurance (75%). Ease of use (86%) and adequate information at enrollment were significantly associated with continued use. Major barriers included technical difficulties (≈80%) and loss of login credentials (>50%). During the study period, 5,214 platform events and more than 4,000 secure messages were recorded, reflecting sustained engagement. APNs required a mean workload of 3 hours per day to manage all active users on a daily basis. Conclusion: Telemonitoring after kidney transplantation is feasible and well accepted, improving perceived access to care and enhancing patient reassurance without measured clinical outcome differences. Adherence is driven primarily by organizational and technological factors rather than patient characteristics. APNs play a central role in ensuring continuity of care, triaging data, and maintaining patient engagement. Future studies should evaluate clinical outcomes and cost-effectiveness to support broader implementation.