Andrews Angela M, Russell Cynthia L
J Gerontol Nurs. 2019 Apr 1;45(4):15-19. doi: 10.3928/00989134-20190212-01.
The purpose of the current study was to examine the feasibility and acceptability of a SystemCHANGE™ intervention in improving medication adherence in older adults with heart failure (HF). Adults age ≥50 years with HF who self-administered diuretics were screened for 2 months using electronic monitoring to determine baseline adherence scores. Participants were randomized into the SystemCHANGE™ or attention-control group if adherence scores were <88%. The SystemCHANGE™ intervention focuses on changing the individual's environment by including medication taking into existing routines, receiving support from individuals who impact routines, and using small experiments with feedback. Challenges were noted by participants in using the electronic medication monitor technology during the screening phase. Lessons learned from this study emphasize the need to revise recruitment procedures and include multiple sites. Education and counseling should be adapted to the cognitive level of the participant and address technology challenges. [Journal of Gerontological Nursing, 45(4), 15-19.].
本研究的目的是检验SystemCHANGE™干预措施在提高老年心力衰竭（HF）患者药物依从性方面的可行性和可接受性。年龄≥50岁且自行服用利尿剂的HF成年患者通过电子监测进行了2个月的筛查，以确定基线依从性得分。如果依从性得分<88%，参与者被随机分为SystemCHANGE™组或注意力控制组。SystemCHANGE™干预措施侧重于通过将服药纳入现有日常活动、从影响日常活动的人那里获得支持以及进行带有反馈的小实验来改变个体的环境。在筛查阶段，参与者指出了使用电子药物监测技术时遇到的挑战。从本研究中吸取的经验教训强调需要修订招募程序并纳入多个地点。教育和咨询应根据参与者的认知水平进行调整，并应对技术挑战。[《老年护理杂志》，45(4)，15 - 19。]
