Herzer Michele, Ramey Christina, Rohan Jennifer, Cortina Sandra
Cincinnati Children's Hospital Medical Center, USA.
Clin Child Psychol Psychiatry. 2012 Oct;17(4):505-18. doi: 10.1177/1359104511421103. Epub 2011 Sep 25.
This paper presents case examples that document the preliminary clinical utility of using electronic monitoring (EM) feedback to tailor empirically validated adherence-promoting interventions, delivered in standard clinical practice. Challenges of utilizing EM in standard clinical practice as well as future directions are also discussed. Two adolescents referred for behavioral adherence promotion intervention are described. Each youth was provided a MEMS® bottle and one oral medication was chosen jointly by the therapist, family, and medical provider for adherence monitoring. Graphical MEMS® feedback was provided to families during intervention visits and subsequently used to tailor adherence interventions to target each family's unique needs. EM feedback was a feasible and clinically rich supplement to adherence-promoting interventions. EM facilitated identification of adherence barriers and successes, and open and non-adversarial discussions regarding adherence between patients, families, and clinicians, and provided real-time representations of patients' medication administration. These case presentations suggest that EM feedback can be a clinically useful tool when used as a supplement to an empirically supported intervention delivered in standard psychological practice aimed at adherence promotion among chronically ill youth.
本文介绍了一些案例，这些案例记录了在标准临床实践中使用电子监测（EM）反馈来定制经过实证验证的促进依从性干预措施的初步临床效用。还讨论了在标准临床实践中使用EM的挑战以及未来的发展方向。描述了两名被转介接受行为依从性促进干预的青少年。为每个青少年提供了一个MEMS®瓶，并由治疗师、家庭和医疗服务提供者共同选择一种口服药物进行依从性监测。在干预访视期间向家庭提供了图形化的MEMS®反馈，随后用于根据每个家庭的独特需求定制依从性干预措施。EM反馈是促进依从性干预措施的一种可行且临床信息丰富的补充。EM有助于识别依从性障碍和成功案例，并促进患者、家庭和临床医生之间就依从性进行开放且非对抗性的讨论，并提供患者用药情况的实时展示。这些案例表明，当EM反馈作为标准心理实践中旨在促进慢性病青少年依从性的实证支持干预措施的补充时，它可以成为一种临床有用的工具。
