Lam Annie Y, Nguyen Juliet K, Parks Jason J, Morisky Donald E, Berry Donna L, Wolpin Seth E
J Am Pharm Assoc (2003). 2017 Jan-Feb;57(1):20-29.e3. doi: 10.1016/j.japh.2016.07.003. Epub 2016 Oct 21.
To test the effect of "Talking Pill Bottles" on medication self-efficacy, knowledge, adherence, and blood pressure readings among hypertensive patients with low health literacy and to assess patients' acceptance of this innovation.
Longitudinal nonblinded randomized trial with standard treatment and intervention arms.
Two community pharmacies serving an ethnically diverse population in the Pacific Northwest. Participants were consented patients with antihypertension prescriptions who screened positive for low health literacy based on the Test of Functional Health Literacy Short Form. Participants in the intervention arm received antihypertensive medications and recordings of pharmacists' counseling in Talking Pill Bottles at baseline. Control arm participants received antihypertensive medications and usual care instructions.
Comparison and score changes between baseline and day 90 for medication knowledge test, Self-Efficacy for Appropriate Medication Use Scale (SEAMS), Morisky Medication Adherence Scale (MMAS-8), blood pressure, and responses to semistructured exit interviews and Technology Acceptance Model surveys.
Of 871 patients screened for health literacy, 134 eligible participants were enrolled in the trial. The sample was elderly, ethnically diverse, of low income, and experienced regarding hypertension and medication history. In both arms, we found high baseline scores in medication knowledge test, SEAMS, and MMAS-8 and minimal changes in these measures over the 90-day study period. Blood pressure decreased significantly in the intervention arm. Acceptability scores for the Talking Pill Bottle technology were high.
Our results suggest that providing audio-assisted medication instructions in Talking Pill Bottles positively affected blood pressure control and was well accepted by patients with low health literacy. Further research involving newly diagnosed patients is needed to mitigate possible ceiling effects that we observed in an experienced population.
测试“会说话的药瓶”对健康素养较低的高血压患者的用药自我效能、知识、依从性和血压读数的影响，并评估患者对这一创新产品的接受程度。
设有标准治疗组和干预组的纵向非盲随机试验。
为太平洋西北地区一个种族多样化的人群服务的两家社区药房。参与者为同意参与研究的高血压处方药患者，根据简化版健康素养功能测试，其健康素养筛查呈阳性。干预组的参与者在基线时收到抗高血压药物以及会说话的药瓶中药剂师咨询的录音。对照组的参与者收到抗高血压药物和常规护理指导。
比较并记录用药知识测试、适当用药自我效能量表（SEAMS）、Morisky药物依从性量表（MMAS-8）、血压在基线和第90天之间的变化，以及对半结构化退出访谈和技术接受模型调查的回答。
在871名接受健康素养筛查的患者中，有134名符合条件的参与者被纳入试验。样本为老年人，种族多样，低收入，且有高血压和用药史。在两组中，我们发现用药知识测试、SEAMS和MMAS-8的基线得分较高，且在90天的研究期内这些指标变化极小。干预组的血压显著下降。会说话的药瓶技术的可接受性得分较高。
我们的结果表明，在会说话的药瓶中提供音频辅助用药说明对血压控制有积极影响，并且受到健康素养较低患者的欢迎。需要对新诊断患者进行进一步研究，以减轻我们在有经验的人群中观察到的可能的天花板效应。
