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一项关于冠心病药物治疗依从性中规划策略有效性的随机对照试验。

A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease.

作者信息

Lourenço Laura Bacelar de Araujo, Rodrigues Roberta Cunha Matheus, Ciol Marcia Aparecida, São-João Thaís Moreira, Cornélio Marilia Estevam, Dantas Rosana Aparecida Spadoti, Gallani Maria-Cecília

机构信息

Faculty of Nursing, University of Campinas, Brazil.

出版信息

J Adv Nurs. 2014 Jul;70(7):1616-28. doi: 10.1111/jan.12323. Epub 2013 Dec 3.

Abstract

AIM

To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease.

BACKGROUND

Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations.

DESIGN

Randomized controlled trial.

METHODS

Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010-May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up.

FINDINGS

When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5.3), but no statistically significant change was observed in the other two outcome measures.

CONCLUSION

This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

摘要

目的

探讨行动和应对计划策略对冠心病门诊患者药物治疗依从性的影响。

背景

行动和应对计划策略基于实施意图,这需要个体进行自我调节,以便在从日常事务到压力情境中,将有意计划的反应置于习得的或习惯性的反应之上。

设计

随机对照试验。

方法

参与者(n = 115)被随机分为干预组(使用行动和应对计划策略,n = 59)或对照组(常规护理,n = 56)。该研究于2010年6月至2011年5月期间进行,分两次现场访视:基线访视和2个月随访。干预组参与者在基线访视和2个月随访之间接受电话强化。在基线访视和2个月随访时,通过依从性比例、依从性评估总体指标和Morisky自我报告药物治疗依从性量表来评估心脏保护和症状缓解药物的依从性。

研究结果

在使用依从性总体指标进行测量时,干预组参与者报告的治疗依从性高于对照组(优势比 = 5.3),但在其他两项结果指标中未观察到统计学上的显著变化。

结论

本研究表明,通过总体依从性评估来衡量,使用行动和应对计划的个体报告的药物治疗依从性更高。需要进行更长随访期的进一步研究,以评估计划策略的效果是否具有长期持续性。

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