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基于办公室的丁丙诺啡项目中使用短信提醒提高患者预约依从性的可行性研究

Text message reminders for improving patient appointment adherence in an office-based buprenorphine program: A feasibility study.

作者信息

Tofighi Babak, Grazioli Frank, Bereket Sewit, Grossman Ellie, Aphinyanaphongs Yindalon, Lee Joshua David

机构信息

Department of Population Health, New York University School of Medicine, New York, New York.

Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, New York.

出版信息

Am J Addict. 2017 Sep;26(6):581-586. doi: 10.1111/ajad.12557. Epub 2017 Aug 11.

Abstract

BACKGROUND AND OBJECTIVES

Missed visits are common in office-based buprenorphine treatment (OBOT). The feasibility of text message (TM) appointment reminders among OBOT patients is unknown.

METHODS

This 6-month prospective cohort study provided TM reminders to OBOT program patients (N = 93). A feasibility survey was completed following delivery of TM reminders and at 6 months.

RESULTS

Respondents reported that the reminders should be provided to all OBOT patients (100%) and helped them to adhere to their scheduled appointment (97%). At 6 months, there were no reports of intrusion to their privacy or disruption of daily activities due to the TM reminders. Most participants reported that the TM reminders were helpful in adhering to scheduled appointments (95%), that the reminders should be offered to all clinic patients (95%), and favored receiving only TM reminders rather than telephone reminders (95%). Barriers to adhering to scheduled appointment times included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic wait-times (9%), being hospitalized or sick (8%), feeling sad or depressed (6%), and child care (6%).

CONCLUSIONS

This study demonstrated the acceptability and feasibility of TM appointment reminders in OBOT. Older age and longer duration in buprenorphine treatment did not diminish interest in receiving the TM intervention. Although OBOT patients expressed concern regarding the privacy of TM content sent from their providers, privacy issues were uncommon among this cohort. Scientific Significance Findings from this study highlighted patient barriers to adherence to scheduled appointments. These barriers included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic lines (9%), and other factors that may confound the effect of future TM appointment reminder interventions. Further research is also required to assess 1) the level of system changes required to integrate TM appointment reminder tools with already existing electronic medical records and appointment records software; 2) acceptability among clinicians and administrators; and 3) financial and resource constraints to healthcare systems. (Am J Addict 2017;26:581-586).

摘要

背景与目的

在基于办公室的丁丙诺啡治疗(OBOT)中,错过就诊很常见。在接受OBOT治疗的患者中,短信预约提醒的可行性尚不清楚。

方法

这项为期6个月的前瞻性队列研究向OBOT项目患者(N = 93)提供短信提醒。在发送短信提醒后以及6个月时完成了一项可行性调查。

结果

受访者表示,应向所有OBOT患者提供提醒(100%),且提醒有助于他们遵守预约安排(97%)。在6个月时,没有报告称短信提醒侵犯了他们的隐私或干扰了日常活动。大多数参与者表示,短信提醒有助于遵守预约安排(95%),应向所有门诊患者提供提醒(95%),并且更倾向于仅接收短信提醒而非电话提醒(95%)。遵守预约时间的障碍包括交通困难(34%)、无法从学校或工作中抽出时间(31%)、门诊等待时间长(9%)、住院或生病(8%)、感到悲伤或抑郁(6%)以及儿童照料(6%)。

结论

本研究证明了短信预约提醒在OBOT中的可接受性和可行性。年龄较大以及丁丙诺啡治疗时间较长并没有降低对接受短信干预的兴趣。尽管接受OBOT治疗的患者对提供者发送的短信内容的隐私表示担忧,但在该队列中隐私问题并不常见。科学意义本研究结果突出了患者遵守预约安排的障碍。这些障碍包括交通困难(34%)、无法从学校或工作中抽出时间(31%)、门诊排队时间长(9%)以及其他可能混淆未来短信预约提醒干预效果的因素。还需要进一步研究来评估:1)将短信预约提醒工具与现有电子病历和预约记录软件集成所需的系统更改程度;2)临床医生和管理人员的可接受性;3)医疗保健系统的财务和资源限制。(《美国成瘾杂志》2017年;26:581 - 586)

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