每日短信提醒可提高功能性消化不良门诊患者的治疗依从性和疗效：一项前瞻性随机对照试验。

Daily Short Message Service Reminders Increase Treatment Compliance and Efficacy in Outpatients with Functional Dyspepsia: a Prospective Randomized Controlled Trial.

作者信息

Wang Bo, Luo Qing-Qing, Li Qing, Cheng Li, Chen Sheng-Liang

机构信息

Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, China.

出版信息

J Gen Intern Med. 2020 Oct;35(10):2925-2931. doi: 10.1007/s11606-020-06088-3. Epub 2020 Aug 10.

DOI:10.1007/s11606-020-06088-3

PMID:32779141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7572925/

Abstract

BACKGROUND

Many outpatients with functional dyspepsia (FD) do not follow the medication schedule recommendations, which can lead to illness relapse.

OBJECTIVE

To investigate whether short message service (SMS) reminders improve medication regimen adherence and therapeutic efficacy in outpatients with FD.

DESIGN

Participants with FD were randomly allocated to the control group or intervention group. Patients in the control group received a 4-week medication treatment with no reminders, those in the intervention group received medication treatment plus a daily SMS reminder of dose and medication time.

PARTICIPANTS

Newly diagnosed FD patients from April 2019 to June 2019 were recruited from the GI outpatient clinics at Renji Hospital.

MEASUREMENTS

The scores for FD symptoms (LDQ) and psychological conditions (PHQ-9 for depression and GAD-7 for anxiety) were assessed before and after the treatment. The medication possession ratio (MPR) was calculated.

KEY RESULTS

A total of 352 eligible patients was enrolled in the study. The overall compliance rates of patients in the intervention and control groups were 87.5% and 80.7% in the intention-to-treat (ITT) analysis (P = 0.08) and 94.48% and 86.59% in per-protocol (PP) analysis (P = 0.015), respectively. In the intervention group, the compliance rate of younger patients (age ≤ 40 years) was significantly higher than that of age-matched patients in the control group (ITT: 86.1% vs. 70.5%, P = 0.018). Compared with the control group, the reduction in scores of LDQ (9.33 vs. 8.02, P = 0.017), PHQ-9 (6.97 vs. 5.69, P = 0.004), and GAD-7 (8.70 vs.7.53, P = 0.028) was significantly greater in patients receiving SMS reminders. The MPR of patients positively correlated with the reduction in scores of LDQ, PHQ-9, and GAD-7 in both groups.

CONCLUSIONS

SMS reminders can improve treatment compliance and efficacy in patients with FD.

TRIAL REGISTRATION

NCT04052750.

摘要

背景

许多功能性消化不良（FD）门诊患者不遵循药物治疗方案建议，这可能导致疾病复发。

目的

研究短信提醒是否能提高FD门诊患者的药物治疗方案依从性和治疗效果。

设计

将FD患者随机分为对照组或干预组。对照组患者接受为期4周的药物治疗，无提醒；干预组患者接受药物治疗并每日收到关于剂量和用药时间的短信提醒。

参与者

2019年4月至2019年6月新诊断的FD患者从仁济医院胃肠门诊招募。

测量

在治疗前后评估FD症状评分（LDQ）和心理状况（抑郁用PHQ - 9，焦虑用GAD - 7）。计算药物持有率（MPR）。

主要结果

共有352名符合条件的患者纳入研究。在意向性分析（ITT）中，干预组和对照组患者的总体依从率分别为87.5%和80.7%（P = 0.08），在符合方案分析（PP）中分别为94.48%和86.59%（P = 0.015）。在干预组中，年轻患者（年龄≤40岁）的依从率显著高于对照组中年龄匹配的患者（ITT：86.1%对70.5%，P = 0.018）。与对照组相比，接受短信提醒的患者LDQ评分降低幅度更大（9.33对8.02，P = 0.017），PHQ - 9评分降低幅度更大（6.97对5.69，P = 0.004），GAD - 7评分降低幅度更大（8.70对7.53，P = 0.028）。两组患者的MPR与LDQ、PHQ - 9和GAD - 7评分降低呈正相关。