Department of Psychological Medicine, University of Auckland, New Zealand.
Br J Health Psychol. 2012 Feb;17(1):74-84. doi: 10.1111/j.2044-8287.2011.02033.x. Epub 2011 Jun 22.
While effective preventative medication is readily available for asthma, adherence is a major problem due to patients' beliefs about their illness and medication. We investigated whether a text message programme targeted at changing patients' illness and medication beliefs would improve adherence in young adult asthma patients.
Two hundred and sixteen patients aged between 16 and 45 on asthma preventer medication were recruited from pamphlets dispensed with medication and e-mails sent to members of a targeted marketing website. Participants were randomized to receive individually tailored text messages based on their illness and medication beliefs over 18 weeks or no text messages. Illness and medication beliefs were assessed at baseline and at 18 weeks. Adherence rates were assessed by phone calls to participants at 6, 12, and 18 weeks and at 6 and 9 months.
At 18 weeks, the intervention group had increased their perceived necessity of preventer medication, increased their belief in the long-term nature of their asthma, and their perceived control over their asthma relative to control group (all p's < .05). The intervention group also significantly improved adherence over the follow-up period compared to the control group with a relative average increase in adherence over the follow-up period of 10% (p < .001). The percentage taking over 80% of prescribed inhaler doses was 23.9% in the control group compared to 37.7% in the intervention group (p < .05).
A targeted text message programme increases adherence to asthma preventer inhaler and may be useful for other illnesses where adherence is a major issue.
虽然有有效的预防药物可用于治疗哮喘,但由于患者对疾病和药物的信念,其用药依从性仍是一个主要问题。我们研究了针对改变患者疾病和药物信念的短信方案是否会改善年轻成年哮喘患者的用药依从性。
从随药物发放的宣传册和针对目标营销网站会员发送的电子邮件中招募了 216 名年龄在 16 至 45 岁之间、正在使用哮喘预防药物的患者。参与者被随机分配接受基于其疾病和药物信念的个性化短信,共 18 周,或不接受短信。在基线和 18 周时评估疾病和药物信念。通过在第 6、12 和 18 周以及第 6 和 9 个月时打电话给参与者来评估用药依从率。
在 18 周时,干预组增加了对预防药物的必要性的认识,增加了对哮喘长期性质的信念,以及对控制哮喘的感知,与对照组相比(均 p<.05)。与对照组相比,干预组在随访期间的用药依从性也显著提高,随访期间的平均依从性相对增加了 10%(p<.001)。对照组中超过 80%处方吸入器剂量的比例为 23.9%,而干预组中这一比例为 37.7%(p<.05)。
有针对性的短信方案可提高哮喘预防吸入器的用药依从性,对于其他用药依从性是主要问题的疾病可能也有用。