Kosse Richelle C, Bouvy Marcel L, de Vries Tjalling W, Kaptein Ad A, Geers Harm Cj, van Dijk Liset, Koster Ellen S
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht.
Department of Paediatrics, Medical Center Leeuwarden, Leeuwarden.
Patient Prefer Adherence. 2017 Mar 16;11:571-577. doi: 10.2147/PPA.S124615. eCollection 2017.
Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control.
The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient's app through the desktop application, which enables the pharmacist to send information and feedback to the patient.
The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient's self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured.
This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases.
哮喘青少年患者的药物依从性差会导致疾病控制不佳和发病率增加。青少年依从性患者工具（ADAPT）研究的目的是开发一种移动健康干预措施，以支持自我管理，并评估其在改善药物依从性和哮喘控制方面的有效性。
ADAPT干预措施包括一个与供医疗保健提供者使用的桌面应用程序相连的交互式智能手机应用程序（应用），在本研究中，该提供者为社区药剂师。该应用包含以下几种提高依从性的功能：1）一个用于对哮喘症状进行评分并随时间监测这些症状的问卷功能；2）带有药物和疾病信息的短视频片段；3）一个药物提醒功能；4）一个与同龄人交流的聊天功能；以及5）一个与药剂师交流的聊天功能。药剂师通过桌面应用程序从患者的应用接收数据，这使药剂师能够向患者发送信息和反馈。
ADAPT干预措施在荷兰一项基于社区药房的整群随机对照试验中进行测试，目标纳入352名哮喘青少年。主要结局是依从性，通过患者自我报告以及根据药房配药记录计算的再配药依从性来衡量。此外，还对哮喘控制、疾病认知、用药信念以及与哮喘相关的生活质量进行测量。
本研究将提供关于移动健康干预措施在支持青少年哮喘自我管理有效性方面的深入知识。这些见解对患有其他慢性病的青少年也将是有用的。
