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一项基于护士和网络的多方面干预措施以提高心血管疾病患者的治疗依从性：MIRROR试验的原理与设计

A Multifaceted Nurse- and Web-Based Intervention for Improving Adherence to Treatment in Patients With Cardiovascular Disease: Rationale and Design of the MIRROR Trial.

作者信息

Sieben Angelien, van Onzenoort Hein Aw, van Laarhoven Kees J, Bredie Sebastian Jh

机构信息

Radboud University Nijmegen Medical Centre, Department of Surgery, Division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.

出版信息

JMIR Res Protoc. 2016 Sep 13;5(3):e187. doi: 10.2196/resprot.5750.

DOI:10.2196/resprot.5750
PMID:27624877
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5039334/
Abstract

BACKGROUND

Poor adherence to medication is one of the limitations in the treatment of cardiovascular diseases, thereby increasing the risk of premature death, hospital admissions, and related costs. There is a need for simple and easy-to-implement interventions that are based on patients' perspectives, beliefs, and perceptions of their illness and medication.

OBJECTIVE

The objective is to test the effectivity of this intervention to improve medication adherence in patients with established cardiovascular disease, that is, in secondary prevention.

METHODS

In this study the effect of a personalized visualization of cardiovascular risk levels through a website aiming at supporting self management in combination with a group consultation and communication intervention by a nurse on adherence to treatment in 600 patients with manifest cardiovascular diseases will be assessed. The health belief model was chosen as main theoretical model for the intervention.

RESULTS

Primary outcome is adherence to treatment calculated by refill data. Secondary outcomes include the Beliefs about Medication Questionnaire and the Modified Morisky Scale. Patients are followed for one year. Results are expected by 2015.

CONCLUSIONS

This study assesses adherence to treatment in a high-risk cardiovascular population by applying an intervention that addresses patients' capacity and practical barriers as well as patients' beliefs and perceptions of their illness and medication.

CLINICALTRIAL

ClinicalTrials.gov NCT01449695; https://clinicaltrials.gov/ct2/show/NCT01449695 (Archived by WebCite at http://www.webcitation.org/6kCzkIKH3).

摘要

背景

药物依从性差是心血管疾病治疗中的局限性之一，从而增加了过早死亡、住院及相关费用的风险。需要基于患者对自身疾病和药物治疗的观点、信念及认知，制定简单且易于实施的干预措施。

目的

目的是测试这种干预措施对改善确诊心血管疾病患者（即二级预防）药物依从性的有效性。

方法

在本研究中，将评估通过一个旨在支持自我管理的网站对心血管风险水平进行个性化可视化展示，并结合护士进行的小组咨询与沟通干预，对600例确诊心血管疾病患者治疗依从性的影响。选择健康信念模型作为干预的主要理论模型。

结果

主要结局指标是通过再填充数据计算的治疗依从性。次要结局指标包括药物治疗信念问卷和改良的Morisky量表。对患者进行为期一年的随访。预计2015年得出结果。

结论

本研究通过应用一种干预措施来评估高危心血管疾病人群的治疗依从性，该干预措施涉及患者的能力和实际障碍，以及患者对自身疾病和药物治疗的信念与认知。

临床试验

ClinicalTrials.gov NCT01449695；https://clinicaltrials.gov/ct2/show/NCT01449695（由WebCite存档于http://www.webcitation.org/6kCzkIKH3）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/9d24484fbd7d/resprot_v5i3e187_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/fc84adac99e2/resprot_v5i3e187_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/9ce94d290081/resprot_v5i3e187_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/16b9792d4816/resprot_v5i3e187_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/7355a0284dfc/resprot_v5i3e187_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/9d24484fbd7d/resprot_v5i3e187_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/fc84adac99e2/resprot_v5i3e187_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/9ce94d290081/resprot_v5i3e187_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/16b9792d4816/resprot_v5i3e187_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/7355a0284dfc/resprot_v5i3e187_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/5039334/9d24484fbd7d/resprot_v5i3e187_fig5.jpg

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