Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
Department Pharmaceutical Care, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
Patient Educ Couns. 2018 Aug;101(8):1419-1426. doi: 10.1016/j.pec.2018.03.017. Epub 2018 Mar 17.
Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects.
A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months.
Intervention effects were found for patient satisfaction with nurses' affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months.
By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence.
Technology can contribute significantly to health care providers' ability to tailor information to the patients' needs.
提高依从性是一个挑战，可能有多种障碍导致不依从。这些障碍因患者而异，且在治疗过程中不断变化。因此，需要针对特定障碍制定个性化的干预措施。在一个基于理论和循证的个性化多媒体干预中，技术（在线预备评估、短信）被用作个性化咨询会议（在沟通技巧培训中学习）的附加手段，预计会产生协同效应。
在六家医院进行了一项集群随机对照试验，涉及八名护士和 160 名慢性患者。在治疗开始时和六个月后评估患者对护士沟通的情感、对药物的信念、自我效能和药物依从性的满意度。
在治疗开始时，干预对患者对护士情感沟通和自我效能的满意度产生了影响。六个月后，自我效能的影响仍然存在。
通过将个性化咨询与技术相结合，该干预措施对药物依从性的重要前提产生了积极的变化。
技术可以大大提高医疗保健提供者根据患者需求定制信息的能力。
