针对老年心力衰竭患者的两种远程医疗用药提醒系统的随机对照可行性试验。
Randomized controlled feasibility trial of two telemedicine medication reminder systems for older adults with heart failure.
作者信息
Goldstein Carly M, Gathright Emily C, Dolansky Mary A, Gunstad John, Sterns Anthony, Redle Joseph D, Josephson Richard, Hughes Joel W
机构信息
Department of Psychology, Kent State University, Kent, Ohio, USA Summa Health System, Akron, Ohio, USA
Department of Psychology, Kent State University, Kent, Ohio, USA Summa Health System, Akron, Ohio, USA.
出版信息
J Telemed Telecare. 2014 Sep;20(6):293-9. doi: 10.1177/1357633X14541039. Epub 2014 Jun 23.
We conducted a feasibility study of a telehealth intervention (an electronic pill box) and an m-health intervention (an app on a smartphone) for improving medication adherence in older adults with heart failure. A secondary aim was to compare patient acceptance of the devices. The participants were 60 adults with HF (65% male). Their average age was 69 years and 83% were Caucasian. Patients were randomized using a 2 × 2 design to one of four groups: pillbox silent, pillbox reminding, smartphone silent, smartphone reminding. We examined adherence to 4 medications over 28 days. The overall adherence rate was 78% (SD 35). People with the telehealth device adhered 80% of the time and people with the smartphone adhered 76% of the time. Those who received reminders adhered 79% of the time, and those with passive medication reminder devices adhered 78% of the time, i.e. reminding did not improve adherence. Patients preferred the m-health approach. Future interventions may need to address other contributors to poor adherence such as motivation.
我们开展了一项可行性研究，评估远程医疗干预措施（电子药盒）和移动医疗干预措施（智能手机应用程序）对提高老年心力衰竭患者用药依从性的效果。次要目的是比较患者对这些设备的接受程度。研究参与者为60名心力衰竭成年患者（65%为男性）。他们的平均年龄为69岁，83%为白种人。患者按2×2设计随机分为四组：药盒无提醒组、药盒有提醒组、智能手机无提醒组、智能手机有提醒组。我们在28天内观察了4种药物的依从性情况。总体依从率为78%（标准差35）。使用远程医疗设备的患者依从率为80%，使用智能手机的患者依从率为76%。接受提醒的患者依从率为79%，使用被动式用药提醒设备的患者依从率为78%，即提醒并未提高依从性。患者更喜欢移动医疗方法。未来的干预措施可能需要解决其他导致依从性差的因素，如动机问题。
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