Schoenthaler Antoinette, Ogedegbe Gbenga
Department of Medicine, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA.
Ann Pharmacother. 2008 May;42(5):647-52. doi: 10.1345/aph.1K640. Epub 2008 Apr 8.
Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices
To assess patients' perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices.
Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients' perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients' responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups.
Participants were predominantly women, low-income, unemployed, had a high school education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the MEMS helped them remember to take their medications, 93% reported that the MEMS was easy to open, 85% did not find it stressful, and 75% liked the MEMS and used it everyday. One-third of patients preferred using a pillbox and 25% did not like traveling with the MEMS. Patients who stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to put refills in the MEMS had significantly better adherence over the study period than did those who disagreed (p </= 0.05).
African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.
电子监测设备（EMD）被视为临床研究中评估药物依从性的金标准。然而，对于在初级保健机构接受随访的非裔美国高血压患者而言，患者对EMD的接受程度对药物依从性的影响却知之甚少。
评估在社区医疗机构接受随访的非裔美国高血压患者对EMD的看法、他们对EMD的接受程度，以及这些看法与药物依从性之间的关系。
患者来自一项规模更大的随机对照试验，该试验评估动机性访谈对在纽约市两家初级保健机构接受随访的高血压非裔美国患者的药物依从性和血压的影响。在为期12个月的监测期内，使用药物事件监测系统（MEMS）评估药物依从性。在12个月的随访中，使用一份包含17个条目的问卷评估患者对MEMS的看法。方差分析用于比较患者在监测期内对MEMS依从性的回答（同意、不确定、不同意）。使用Tukey事后检验来确定三组之间是否存在显著差异。
参与者主要为女性，低收入，失业，具有高中学历，平均年龄为53岁。约三分之二的参与者表示MEMS帮助他们记住服药，93%报告MEMS易于打开，85%认为使用它没有压力，75%喜欢MEMS并每天使用。三分之一的患者更喜欢使用药盒，25%不喜欢携带MEMS出行。表示每天使用MEMS、在他人面前使用感觉自在且记得往MEMS中装入补充药物的患者在研究期间的依从性明显优于不同意这些看法的患者（p≤0.05）。
在社区医疗机构接受高血压治疗的非裔美国患者对MEMS持积极看法。对MEMS实用性的看法可能会产生有关实际服药行为的重要信息。
