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随机电话咨询试验以提高参与者在血管筛查试验中对规定药物的依从性。

Randomised trial of telephone counselling to improve participants' adherence to prescribed drugs in a vascular screening trial.

机构信息

Department of Cardiology, Diagnostic Centre, Regional Hospital Central Jutland, Silkeborg, Denmark.

The Centre for Nursing Research, Viborg, Denmark.

出版信息

Basic Clin Pharmacol Toxicol. 2020 Dec;127(6):477-487. doi: 10.1111/bcpt.13459. Epub 2020 Jul 16.

Abstract

A total of 1446 participants, 65- to 74-year-old men diagnosed with abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD) or high blood pressure (HB) in the Viborg Vascular (VIVA) screening trial, were consecutively included and randomised to a telephone counselling (TC) or no TC 3 months after being screened positive. Data from VIVA were linked to data from Danish registers from 2007 to 2016. The primary outcome was a composite outcome of proportion of days covered by statin, antithrombotic drugs and antihypertensive agents and for each specific drug class at 6-month follow-up. The same outcomes were assessed at 12 and 60 months and considered secondary outcomes. Outcome measures are reported as risk differences (RD). There were no differences between the groups in relation to the composite of all three drug classes over 6 months of follow-up, RD = 4.1 (95% CI: -1.0; 9.1). A significant increase in redeemed statin prescriptions was observed in the intervention group at 6 months, RD = 9.8% (CI 95%: 0.5; 19.0). There was no intervention effect observed after 12 and 60 months. TC 3 months after screening improved adherence to statin at 6-month follow-up, but had no effect on the composite treatment, statins, antithrombotic or antihypertensive treatment over 60 months of follow-up.

摘要

共有 1446 名参与者,年龄在 65 至 74 岁之间,在 Viborg 血管 (VIVA) 筛查试验中被诊断出患有腹主动脉瘤 (AAA)、外周动脉疾病 (PAD) 或高血压 (HB),连续入选并随机分为电话咨询 (TC) 组或无 TC 组,在筛查阳性后 3 个月。VIVA 的数据与 2007 年至 2016 年丹麦登记处的数据相关联。主要结局是他汀类药物、抗血栓药物和抗高血压药物的覆盖天数比例的复合结局,以及每种特定药物类别的 6 个月随访。在 12 个月和 60 个月时评估了相同的结局,并被认为是次要结局。结果测量报告为风险差异 (RD)。在 6 个月的随访中,三组药物的复合结果在两组之间没有差异,RD=4.1 (95%CI:-1.0; 9.1)。干预组在 6 个月时观察到他汀类药物处方的显著增加,RD=9.8% (CI 95%:0.5; 19.0)。在 12 个月和 60 个月后没有观察到干预效果。筛查后 3 个月的 TC 可改善他汀类药物的依从性,在 6 个月的随访中,但对复合治疗、他汀类药物、抗血栓或降压治疗无影响,随访 60 个月。

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