J Am Pharm Assoc (2003). 2019 Mar-Apr;59(2S):S44-S51.e3. doi: 10.1016/j.japh.2018.12.012. Epub 2019 Feb 1.
To assess the impact of a customizable medication management mobile app (Medsimple) on medication adherence and adherence-related beliefs in patients with type 2 diabetes. The app contains a medication database, list tracking, reminders, cost-saving information, and other features. A second objective was to determine differentiating factors associated with 6 months of use.
A prospective, observational, single-cohort study using previously tested scales at 3 time points over 6 months.
Participants included a convenience sample of community-dwelling adults with type 2 diabetes in the United States who used at least 2 prescriptions, had Internet access, and used e-mail and a mobile device for operating the study app.
Participants who served as their own controls were assessed on psychosocial theory-based concepts of self-efficacy, locus of control, and outcome expectations in addition to self-reported adherence. Instrument reliability, repeated assessments, and differential dropout analyses were conducted.
Repeated assessments of 51, 49, and 41 participants occurred at baseline and 90 and 180 days (6 months), respectively. Instrument measurement of concepts showed strong reliability, except in the locus of control subscales. Participants exhibited no significant change on the scales of self-reported adherence behaviors or adherence-related beliefs during the study. Results showed that the mobile app may have influenced specific adherence behaviors or beliefs, but significant differences on overall scales were not found. Differential dropout analyses comparing study finishers to dropouts revealed that 6-month use was associated with being younger, lower self-efficacy beliefs, lower internal locus of control beliefs, and lower adherence behaviors.
Scales were reliable to measure concepts but the locus of control scale warrants further testing. The mobile app may not affect adherence and adherence-related beliefs in a 6-month period. Further testing is needed to determine benefit for patients with specific adherence behaviors or who hold certain beliefs.
评估一款可定制的药物管理移动应用程序（Medsimple）对 2 型糖尿病患者药物依从性和与依从性相关的信念的影响。该应用程序包含药物数据库、清单跟踪、提醒、节省成本的信息和其他功能。第二个目标是确定与 6 个月使用相关的区别因素。
一项前瞻性、观察性、单队列研究，在 6 个月内的 3 个时间点使用经过先前测试的量表。
参与者包括美国社区居住的 2 型糖尿病成年人的便利样本，他们使用了至少 2 种处方，有互联网访问权限，并且使用电子邮件和移动设备来操作研究应用程序。
作为自身对照的参与者除了自我报告的依从性外，还评估了基于心理社会理论的自我效能、控制源和结果预期等概念。进行了仪器可靠性、重复评估和差异辍学分析。
分别在基线和 90 天（6 个月）和 180 天进行了 51、49 和 41 名参与者的重复评估。概念的仪器测量显示出很强的可靠性，除了控制源的子量表外。在研究期间，参与者在自我报告的依从性行为或与依从性相关的信念量表上没有显示出显著变化。结果表明，移动应用程序可能影响了特定的依从性行为或信念，但在总体量表上没有发现显著差异。比较研究完成者和辍学者的差异辍学分析表明，6 个月的使用与年龄较小、自我效能信念较低、内部控制源信念较低以及依从性行为较低有关。
量表可靠地测量概念，但控制源量表需要进一步测试。移动应用程序可能不会在 6 个月内影响依从性和与依从性相关的信念。需要进一步测试，以确定对具有特定依从性行为或具有特定信念的患者的益处。
