Glanz Karen, Beck Allen D, Bundy Lucja, Primo Susan, Lynn Michael J, Cleveland Julia, Wold Jessica A, Echt Katharina V
Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, USA.
Arch Ophthalmol. 2012 Oct;130(10):1252-8. doi: 10.1001/archophthalmol.2012.1607.
To determine the efficacy of an automated, interactive, telephone-based health communication intervention for improving glaucoma treatment adherence among patients in 2 hospital-based eye clinics.
A total of 312 patients with glaucoma (18-80 years of age) were enrolled in a randomized controlled trial at 2 eye clinics located in hospitals in the southeastern United States. These patients were considered nonadherent because they did not take their medication, refill their medication, and/or keep their appointments. The treatment group received an automated, interactive, tailored, telephone-based health communication intervention and tailored print materials. The control group received usual care.
Adherence with medication taking, prescription refills, and appointment keeping measured by interviews, medical charts, appointment records, and pharmacy data.
A statistically significant increase was found for all adherence measures in both the intervention and control groups. Interactive telephone calls and tailored print materials did not significantly improve adherence measures compared with controls.
During the study period, patient adherence to glaucoma treatment and appointment keeping improved in both study arms. Participation in the study and interviews may have contributed. Strategies that address individuals' barriers and facilitators may increase the impact of telephone calls, especially for appointment keeping and prescription refills.
Glaucoma patient care should include reminders about consistent use of medication and the importance of keeping appointments. More frequent, and personalized, telephone contact may be helpful to patients who are known to be nonadherent.
clinicaltrials.gov Identifier:NCT00794170.
确定一种基于电话的自动化、交互式健康沟通干预措施,对改善两家医院眼科门诊患者青光眼治疗依从性的效果。
在美国东南部医院的两家眼科门诊,共312例青光眼患者(年龄18 - 80岁)参与了一项随机对照试验。这些患者被视为治疗依从性差,因为他们未按时服药、未及时补充药物以及/或者未按时就诊。治疗组接受基于电话的自动化、交互式、个性化健康沟通干预以及个性化印刷材料。对照组接受常规护理。
通过访谈、病历、就诊记录和药房数据来衡量服药、处方续签和就诊的依从性。
干预组和对照组的所有依从性指标均有统计学意义的提高。与对照组相比,交互式电话和个性化印刷材料并未显著改善依从性指标。
在研究期间,两个研究组的患者对青光眼治疗的依从性和就诊率均有所提高。参与研究和访谈可能起到了一定作用。针对个体障碍和促进因素的策略可能会增强电话沟通的效果,尤其是在就诊和处方续签方面。
青光眼患者护理应包括提醒患者持续用药以及按时就诊的重要性。对于已知依从性差的患者,更频繁、个性化的电话联系可能会有所帮助。
clinicaltrials.gov标识符:NCT00794170。