Park Linda G, Ng Fion, K Shim Janet, Elnaggar Abdelaziz, Villero Ofelia
Department of Veterans Affairs Medical Center, USA.
University of California, San Francisco School of Nursing, USA.
Digit Health. 2020 May 20;6:2055207620926844. doi: 10.1177/2055207620926844. eCollection 2020 Jan-Dec.
Medication non-adherence is linked to adverse clinical outcomes (i.e. rehospitalization, mortality) among patients with coronary heart disease. Given its global adoption and growing popularity among older adults, mobile technology may be an effective strategy to improve medication adherence. The aim of this article is to present the perceptions, attitudes, and beliefs of individuals with coronary heart disease about using text messaging and mobile phone applications for medication adherence.
We recruited 28 participants (veterans and non-veterans) with a history of coronary heart disease and antiplatelet medication use in Northern California. We formed six focus groups of individuals who participated in three sessions (total 18 sessions). We analyzed our data using grounded theory.
The median age was 69.5 ± 10.8 years for non-veterans (50% male) and 70 ± 8.6 years for veterans (100% male). In the first session, we found that participants perceived text message reminders as a convenient, easy, and flexible tool to establish a routine for taking medications. In the second session, participants were eager to use applications for their greater interactivity, individualized health monitoring, and personalized medication information. The third session, participants shared preferred features (i.e. drug interactions, tracking symptoms) after using two applications at home for 2 weeks.
Older adults are engaged and can be proficient mobile technology users. Text messaging and mobile phone applications are perceived as helpful tools for medication adherence. Future research should include rigorous clinical trials to test the efficacy of mobile health technology to promote medication adherence in populations that require strict medication adherence.
冠心病患者的药物治疗不依从与不良临床结局（即再次住院、死亡率）相关。鉴于移动技术在全球的广泛应用及其在老年人中的日益普及，它可能是提高药物治疗依从性的有效策略。本文旨在阐述冠心病患者对于使用短信和手机应用程序来提高药物治疗依从性的看法、态度和信念。
我们在北加利福尼亚招募了28名有冠心病病史且正在使用抗血小板药物的参与者（退伍军人和非退伍军人）。我们组建了六个焦点小组，每组人员参加三次会议（共18次会议）。我们运用扎根理论分析数据。
非退伍军人的中位年龄为69.5±10.8岁（50%为男性），退伍军人的中位年龄为70±8.6岁（100%为男性）。在第一次会议中，我们发现参与者将短信提醒视为建立服药常规的便捷、简单且灵活的工具。在第二次会议中，参与者渴望使用应用程序，因为它们具有更强的交互性、个性化健康监测和个性化用药信息。在第三次会议中，参与者在在家中使用两款应用程序两周后分享了他们喜欢的功能（即药物相互作用、症状跟踪）。
老年人积极参与且能够熟练使用移动技术。短信和手机应用程序被视为有助于提高药物治疗依从性的工具。未来的研究应包括严格的临床试验，以测试移动健康技术在需要严格药物治疗依从性的人群中促进药物治疗依从性的效果。
