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改善慢性病患者用药依从性的个人健康记录的重要设计特征:系统文献综述方案

Important Design Features of Personal Health Records to Improve Medication Adherence for Patients with Long-Term Conditions: Protocol for a Systematic Literature Review.

作者信息

Andrikopoulou Elisavet, Scott Philip James, Herrera Helena

机构信息

School of Computing, Faculty of Technology, University of Portmouth, Portsmouth, United Kingdom.

School of Pharmacy and Biomedical Sciences, Faculty of Science, University of Portmouth, Portsmouth, United Kingdom.

出版信息

JMIR Res Protoc. 2018 Jun 28;7(6):e159. doi: 10.2196/resprot.9778.

Abstract

BACKGROUND

The National Health Service (NHS) England spent £15.5 billion on medication in 2015. More than a third of patients affected by at least one long-term condition do not adhere to their drug regime. Many interventions have been trialed to improve medication adherence. One promising innovation is the electronic personal health record.

OBJECTIVE

This systematic literature review aims to identify the important design features of personal health records to improve medication adherence for patients with long-term conditions.

METHODS

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P 2015) statement. The following databases will be searched for relevant articles: PubMed, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. Studies published in the last fifteen years, in English, will be included if the participants are adults who were treated outside the hospital, have the ability to self-administer their medication, and have at least one long-term condition. The review will exclude commercial or political sources and papers without references. Papers that research pediatrics, pregnant, or terminally ill patients will also be excluded, since their medication management is typically more complex.

RESULTS

One reviewer will screen the included studies, extract the relevant data, and assess the quality of evidence utilizing the Grading of Recommendations Assessment, Development, and Evaluation system and the risk of bias using the Cochrane RevMan tool. The second reviewer will assess the quality of 25% of the included studies to assess interrater agreement. Any disagreement will be solved by a third reviewer. Only studies of high and moderate quality will be included for narrative synthesis.

CONCLUSIONS

NHS policy assumes that increasing usage of personal health records by citizens will reduce demand on health care services. There is limited evidence, however, that the use of health apps can improve patient outcomes, and, to our knowledge, this is the first systematic literature review aiming to identify important design features of the personal health record which may improve medication adherence in the adult population with long-term conditions.

TRIAL REGISTRATION

PROSPERO CRD42017060542; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=60542 (Archived by WebCite at http://www.webcitation.org/6zeuWXxVh).

REGISTERED REPORT IDENTIFIER

RR1-10.2196/9778.

摘要

背景

2015年,英国国家医疗服务体系(NHS)在药物治疗方面花费了155亿英镑。超过三分之一受至少一种长期疾病影响的患者不遵守其药物治疗方案。已经尝试了许多干预措施来提高药物治疗的依从性。一种有前景的创新是电子个人健康记录。

目的

本系统文献综述旨在确定个人健康记录的重要设计特征,以提高长期疾病患者的药物治疗依从性。

方法

本方案遵循系统评价与Meta分析方案的首选报告项目(PRISMA-P 2015)声明。将在以下数据库中搜索相关文章:PubMed、科学Direct、BioMed Central、护理及相关健康文献累积索引、Cochrane系统评价数据库和Cochrane对照试验中心注册库。如果参与者为在院外接受治疗、有能力自行用药且至少患有一种长期疾病的成年人,则纳入过去15年以英文发表的研究。该综述将排除商业或政治来源以及无参考文献的论文。研究儿科、孕妇或绝症患者的论文也将被排除,因为他们的药物管理通常更为复杂。

结果

一名评审员将筛选纳入的研究,提取相关数据,并使用推荐分级评估、制定和评价系统评估证据质量,使用Cochrane RevMan工具评估偏倚风险。第二名评审员将评估25%纳入研究的质量,以评估评分者间的一致性。任何分歧将由第三名评审员解决。只有高质量和中等质量的研究才会纳入叙述性综合分析。

结论

NHS政策认为,公民增加个人健康记录使用量将减少对医疗服务的需求。然而,仅有有限的证据表明使用健康应用程序可改善患者结局,据我们所知,这是第一项旨在确定可能改善长期疾病成年人群药物治疗依从性的个人健康记录重要设计特征的系统文献综述。

试验注册

PROSPERO CRD42017060542;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=60542(由WebCite存档于http://www.webcitation.org/6zeuWXxVh)。

注册报告识别码

RR1-10.2196/9778。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ee/6116916/120b1161442f/resprot_v7i6e159_fig1.jpg

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