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基于网络和智能手机的慢性病患者药物自我管理平台的可行性和初步结果。

Feasibility and Preliminary Outcomes of a Web and Smartphone-Based Medication Self-Management Platform for Chronically Ill Patients.

机构信息

Pharmacy Service, Hospital Clínic Barcelona, Villarroel, 170 08036, Barcelona, Spain.

Consorci d'Atenció Primària de l'Eixample Casanova, GrupTransversal de Recerca en Atenció Primària, IDIBAPS, University of Barcelona, Barcelona, Spain.

出版信息

J Med Syst. 2016 Apr;40(4):99. doi: 10.1007/s10916-016-0456-y. Epub 2016 Feb 12.

Abstract

OBJECTIVE

The aim of this study was to assess the feasibility and preliminary outcomes of a medication self-management platform for chronically ill patients, Medplan.

METHODS

We performed a 6-month single-arm prospective pre-post intervention study of patients receiving treatment for hypertension and/or dyslipidemia and/or heart failure and/or human immunodeficiency virus infection. During the pre-intervention phase, participants were followed according to their usual care; during the intervention phase, they used Medplan. We evaluated adherence, health outcomes, healthcare resources and measured the satisfaction of patients and health care professionals.

RESULTS

The study population comprised 42 patients. No differences were found in adherence to medication measured by proportion of days covered with medication (PDC). However, when adherence was measured using the SMAQ, the percentage of adherent patients improved during the intervention phase (p < 0.05), and the number of days with missed doses decreased (p < 0.05). Adherence measured using the Medplan app showed poor concordance with PDC. No differences were found in health outcomes or in the use of health care resources during the study period. The mean satisfaction score for Medplan was 7.2 ± 2.7 out of 10 among patients and 7.3 ± 1.7 among health care professionals. In fact, 71.4 % of participants said they would recommend the app to a friend, and 88.1 % wanted to continue using it.

CONCLUSION

The Medplan platform proved to be feasible and was well accepted by its users. However, its impact on adherence differed depending on the assessment method. The lack of effect on PDC is mainly because patients were already good adherers at baseline. The study enabled us to validate the platform in real patients using many different mobile devices and to identify potential barriers to scaling up the platform.

摘要

目的

本研究旨在评估用于慢性病患者的药物自我管理平台 Medplan 的可行性和初步结果。

方法

我们对接受高血压和/或血脂异常和/或心力衰竭和/或人类免疫缺陷病毒感染治疗的患者进行了为期 6 个月的单臂前瞻性前后干预研究。在干预前阶段,参与者根据其常规护理进行随访;在干预阶段,他们使用 Medplan。我们评估了依从性、健康结果、医疗资源,并测量了患者和医疗保健专业人员的满意度。

结果

研究人群包括 42 名患者。药物依从性(以用药天数覆盖率衡量)无差异。然而,当使用 SMAQ 衡量时,在干预阶段,依从性患者的比例提高(p < 0.05),错过剂量的天数减少(p < 0.05)。使用 Medplan 应用程序测量的依从性与 PDC 一致性较差。在研究期间,健康结果或医疗资源的使用无差异。患者对 Medplan 的平均满意度评分为 10 分中的 7.2 ± 2.7,医疗保健专业人员的平均满意度评分为 7.3 ± 1.7。实际上,71.4%的参与者表示他们会向朋友推荐该应用程序,88.1%的人希望继续使用它。

结论

Medplan 平台被证明是可行的,并且受到了用户的欢迎。然而,其对依从性的影响取决于评估方法。对 PDC 没有影响的主要原因是患者在基线时已经具有良好的依从性。该研究使我们能够在实际患者中使用许多不同的移动设备验证该平台,并确定扩大平台的潜在障碍。

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