Russell Cynthia L, Miller Courtney, Remy Laura M, Wessol Jennifer L, Andrews Angela M, Aholt Dana, Clark Debra, Hardinger Karen, O'Brien Tara, Hathaway Donna, Goggin Kathy
Professor, University of Missouri - Kansas City, School of Nursing and Health Studies, Kansas City, MO.
Research Assistant, University of Missouri - Kansas City, School of Nursing and Health Studies, Kansas City, MO.
Nephrol Nurs J. 2018 Mar-Apr;45(2):171-223.
This article reports a case study of an older adult kidney transplant recipient with poor medication adherence enrolled in an innovative six-month SystemCHANGE intervention that seeks to systematically improve medication adherence by identifying and shaping routines, involving others in routines, and using medication-taking feedback through small, patient-led experiments. Medication adherence increased immediately and was sustained throughout the intervention and maintenance phases. This is the first case study to demonstrate effectiveness of the SystemCHANGE intervention for promoting medication adherence in a kidney transplant recipient. The intervention improved the timing of doses by linking them to a regularly occurring behavior and providing feedback. The SystemCHANGE intervention represents a systems-thinking approach for both provider and patients, and gives healthcare providers the tools needed to assist patients in using habits and routines, and feedback to improve medication taking and timing.
本文报告了一例老年肾移植受者药物依从性差的案例研究，该受者参与了一项为期六个月的创新型“系统改变”干预措施，该措施旨在通过识别和塑造日常行为、让他人参与日常行为以及通过小规模的、患者主导的实验利用服药反馈来系统性地提高药物依从性。药物依从性在干预期间立即提高，并在整个干预和维持阶段得以保持。这是首个证明“系统改变”干预措施对促进肾移植受者药物依从性有效的案例研究。该干预措施通过将服药时间与经常发生的行为联系起来并提供反馈，改善了服药时间。“系统改变”干预措施为医疗服务提供者和患者提供了一种系统思维方法，并为医疗服务提供者提供了帮助患者利用习惯和日常行为以及反馈来改善服药和服药时间所需的工具。
