Tabula Rasa HealthCare Group, Tucson, AZ, USA.
SinfoniaRx, Tucson, AZ, USA.
Ann Pharmacother. 2021 May;55(5):637-649. doi: 10.1177/1060028020950726. Epub 2020 Aug 20.
To describe telehealth interventions and determine their effect on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia.
PubMed/MEDLINE, EMBASE, Cochrane, CINAHL Plus, PsycINFO, Academic Search Ultimate, International Pharmaceutical Abstracts, Scopus, Web of Science, WHO Global Index Medicus, association websites, and gray literature were searched from January 1, 1998, to December 31, 2019.
Eligible studies reported eHealth, mobile health, and telehealth interventions for adult patients prescribed medications for chronic condition management (eg, type 2 diabetes, hypertension, and/or dyslipidemia). Studies were required to evaluate medication adherence outcomes (eg, medication possession ratio [MPR], proportion of days covered (PDC)]. Randomized controlled trials, cohort studies, and controlled before-and-after studies were included. Multiple reviewers independently extracted data and evaluated risk of bias.
Of 8693 studies identified, 13 reported either an MPR or PDC and were included in the systematic review. The systematic review demonstrated that electronic health (eHealth) and telehealth interventions were successful at improving medication adherence, whereas mobile health interventions did not improve medication adherence.
This systematic review highlighted the available research and findings of studies assessing interventions to improve medication nonadherence among patients with type 2 diabetes, hypertension, and/or dyslipidemia. The evaluated findings lend support to the need for targeted medication adherence interventions based on patient population and practice settings.
Telehealth modalities include telephonic outreach and specialized tools designed to increase health literacy. eHealth and telehealth medication adherence interventions were associated with improved MPR and/or PDC rates.
描述远程医疗干预措施,并确定其对 2 型糖尿病、高血压和/或血脂异常患者药物依从性的影响。
从 1998 年 1 月 1 日至 2019 年 12 月 31 日,检索了 PubMed/MEDLINE、EMBASE、Cochrane、CINAHL Plus、PsycINFO、Academic Search Ultimate、国际药学文摘、Scopus、Web of Science、世界卫生组织全球医学索引、协会网站和灰色文献。
符合条件的研究报告了电子健康、移动健康和远程医疗干预措施,用于管理慢性疾病(如 2 型糖尿病、高血压和/或血脂异常)的成年患者处方药物。研究需要评估药物依从性结果(例如,药物持有率[MPR]、覆盖天数比例[PDC])。包括随机对照试验、队列研究和对照前后研究。多名评审员独立提取数据并评估偏倚风险。
在 8693 项研究中,有 13 项报告了 MPR 或 PDC,并被纳入系统评价。系统评价表明,电子健康(eHealth)和远程医疗干预措施成功地提高了药物依从性,而移动健康干预措施并没有提高药物依从性。
本系统评价强调了现有研究和评估改善 2 型糖尿病、高血压和/或血脂异常患者药物不依从性干预措施的研究结果。评估结果支持根据患者人群和实践环境制定有针对性的药物依从性干预措施的必要性。
远程医疗模式包括电话外呼和专门设计的提高健康素养的工具。电子健康和远程医疗药物依从性干预措施与提高 MPR 和/或 PDC 率相关。