基于短信和智能手机的干预措施对改善慢性病青少年药物依从性的经济学评价：一项系统综述。
Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review.
作者信息
Badawy Sherif M, Kuhns Lisa M
机构信息
Ann and Robert H Lurie Children's Hospital of Chicago, Department of Pediatrics, Division of Hematology, Oncology, and Stem Cell Transplant, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
出版信息
JMIR Mhealth Uhealth. 2016 Oct 25;4(4):e121. doi: 10.2196/mhealth.6425.
BACKGROUND
The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking.
OBJECTIVE
The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs.
METHODS
Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes.
RESULTS
Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation.
CONCLUSIONS
The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.
背景
在过去20年中，儿童和青少年慢性健康状况（CHC）的发生率翻了一番，医疗保健成本也有所增加。基于技术的干预措施已证明对提高药物依从性有效。然而，缺乏支持这些干预措施成本效益的数据。
目的
本研究的目的是对以短信和智能手机为基础的干预措施进行经济评估，这些干预措施旨在提高患有CHC的青少年的药物依从性。
方法
检索包括PubMed MEDLINE、Embase、Cochrane对照试验中央注册库、护理及相关健康文献累积索引、PsycINFO、科学引文索引和Inspec。纳入标准包括年龄（12 - 24岁）、原始文章、药物依从性结果和经济结果。
结果
我们的检索共识别出1118篇独立筛选的独特文章。共有156篇文章符合纳入标准，随后进行了全文独立审查。共有15篇文章符合大多数标准，但缺乏成本效益或成本效用数据等经济结果。没有文章符合所有预定义标准以纳入最终审查。只有4篇文章（短信干预[n = 3]，电子直接观察治疗[n = 1]）描述了可能具有未来成本节约效果的干预措施，但没有正式的经济评估。
结论
支持短信和智能手机干预措施在提高患有CHC的青少年药物依从性方面成本效益的证据不足。这种研究的缺乏凸显了对此类干预措施进行全面经济评估的必要性，以便更好地了解它们在节约成本同时提高药物依从性和健康结果方面的作用。基于技术的干预措施的经济评估有助于更基于证据地评估此类技术工具在患有CHC的青少年中更广泛投资的可扩展性、可持续性和益处。
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