高血压合并双相障碍患者的心理教育和短信依从性干预的结果。
Outcomes of Psychoeducation and a Text Messaging Adherence Intervention Among Individuals With Hypertension and Bipolar Disorder.
机构信息
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland (Levin, Sajatovic, Rahman, Aebi, Cassidy, Blixen, Klein, Fuentes-Casiano); Neurological and Behavioral Outcomes Center (Levin, Sajatovic, Tatsuoka, Blixen) and Department of Medicine (Rahman), University Hospitals Cleveland Medical Center, Cleveland; Department of Psychiatry, University of California, San Diego, La Jolla (Depp, Cushman, Johnston, Moore); Department of Psychology, Cleveland State University, Cleveland (Eskew).
出版信息
Psychiatr Serv. 2019 Jul 1;70(7):608-612. doi: 10.1176/appi.ps.201800482. Epub 2019 Apr 17.
OBJECTIVE
This study evaluated the feasibility, acceptability, and preliminary efficacy of psychoeducation plus an automated text messaging intervention (Individualized Texting for Adherence Building-Cardiovascular [iTAB-CV]) to improve adherence to antihypertensives and bipolar disorder medication.
METHODS
After a psychoeducation program, iTAB-CV was administered for 2 months. In month 1, participants received one educational-motivational and one mood rating text daily. In month 2, medication reminders were added.
RESULTS
The sample (N=38) was 74% African American and 53% women, with a mean±SD age of 51.53±9.06. Antihypertensive nonadherence decreased from a mean of 43%±23% to 21%±18% at 12 weeks (χ=34.6, df=3, p<0.001). Systolic blood pressure decreased from a mean of 144.8±15.5 mmHg to 136.0±17.8 mmHg (χ=17.6, df=3, p<.001). Retention was 100%.
CONCLUSIONS
In this uncontrolled trial, participants were highly engaged and medication adherence and reduced systolic blood pressure were sustained after psychoeducation plus iTAB-CV. Because iTAB-CV is automated and delivered remotely, it has the potential to reach a large and challenging population.
目的
本研究评估了在接受降压药和双相情感障碍药物治疗的患者中开展心理教育联合自动化文本信息干预（个体化短信增强药物依从性-心血管疾病[ITAB-CV]）的可行性、可接受性和初步疗效。
方法
在心理教育计划后，实施 iTAB-CV 干预 2 个月。在第 1 个月，参与者每天接收一条教育动机和一条情绪评分短信。在第 2 个月，增加药物提醒。
结果
样本（N=38）中 74%为非裔美国人，53%为女性，平均年龄为 51.53±9.06 岁。12 周时，降压药不依从率从 43%±23%降至 21%±18%（χ=34.6，df=3，p<0.001）。收缩压从 144.8±15.5mmHg 降至 136.0±17.8mmHg（χ=17.6，df=3，p<.001）。保留率为 100%。
结论
在这项非对照试验中，参与者高度参与，在接受心理教育联合 iTAB-CV 后，药物依从性提高，收缩压降低，且效果持续。由于 iTAB-CV 是自动化的，并通过远程方式提供，因此具有覆盖大量具有挑战性的患者群体的潜力。
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