确认专家编写的短信的理论结构，以提高抗高血压药物的依从性。
Confirming the theoretical structure of expert-developed text messages to improve adherence to anti-hypertensive medications.
作者信息
Farris Karen B, Salgado Teresa M, Batra Peter, Piette John D, Singh Satinder, Guhad Ahmed, Newman Sean, Marshall Vincent D, An Larry
机构信息
Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, USA.
Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, USA.
出版信息
Res Social Adm Pharm. 2016 Jul-Aug;12(4):578-91. doi: 10.1016/j.sapharm.2015.09.009. Epub 2015 Oct 3.
BACKGROUND
Text messages can improve medication adherence and outcomes in several conditions. For this study, experts developed text messages addressing determinants of medication adherence: disease beliefs, medication necessity, medication concerns, and forgetfulness, as well as positive reinforcement messages for patients who were adherent.
OBJECTIVES
To validate expert-developed text messages to address medication non-adherence with a group of non-researchers.
METHODS
A two-wave, card-sorting activity was conducted with students and staff at the University of Michigan. In the first wave, 40 participants grouped 32 messages addressing barriers for medication adherence (disease beliefs, medication necessity, medication concerns, and forgetfulness) according to their perceived relationship. Messages with poor grouping agreement were deleted or modified. In the second wave, positive reinforcement messages were developed and tested along with the previous categories (36 messages) by 37 participants. Similarity and cluster analyses were used to assess agreement between experts and participants.
RESULTS
In the first card-sorting wave, participants grouped messages into between 2 and 13 separate categories. Similarity analysis showed four groupings of messages, however, some had an agreement below 50% and clusters appeared dispersed. In the second wave, and after messages being edited, participants grouped the messages into between 4 and 9 categories. Five groups (now including positive reinforcement messages) were identified with higher agreement in the similarity and cluster analyses.
CONCLUSIONS
The structure of expert-developed text messages to address medication adherence key barriers was confirmed. Messages will be used in future research to determine their impact on affecting medication adherence to anti-hypertensive medications using a reinforcement learning controlled text messaging service.
背景
短信可以提高多种疾病情况下的药物依从性及治疗效果。在本研究中，专家们编写了针对药物依从性决定因素的短信：疾病认知、药物必要性、药物相关顾虑和遗忘问题，以及针对依从性良好患者的积极强化信息。
目的
与一组非研究人员共同验证专家编写的用于解决药物不依从问题的短信。
方法
对密歇根大学的学生和工作人员开展了两阶段的卡片分类活动。在第一阶段，40名参与者根据他们的认知关系，将32条针对药物依从性障碍（疾病认知、药物必要性、药物相关顾虑和遗忘问题）的短信进行分组。分组一致性较差的短信被删除或修改。在第二阶段，37名参与者对积极强化信息以及之前的类别（36条短信）进行了开发和测试。使用相似性分析和聚类分析来评估专家与参与者之间的一致性。
结果
在第一轮卡片分类中，参与者将短信分成了2至13个不同类别。相似性分析显示短信分为四类，然而，有些类别的一致性低于50%，且聚类显得分散。在第二轮中，经过短信编辑后，参与者将短信分成了4至9个类别。在相似性分析和聚类分析中，确定了五组（现在包括积极强化信息）具有更高的一致性。
结论
确认了专家编写的用于解决药物依从性关键障碍的短信结构。这些短信将用于未来的研究，以确定使用强化学习控制的短信服务对影响抗高血压药物依从性的作用。
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