患者使用智能手机应用程序支持自我管理和改善高血压药物依从性的体验:定性研究。

Patients' Experiences of Using Smartphone Apps to Support Self-Management and Improve Medication Adherence in Hypertension: Qualitative Study.

机构信息

School of Psychology, National Univeristy of Ireland Galway, Galway, Ireland.

Health Behaviour Change Research Group, National Univiersity of Ireland Galway, Galway, Ireland.

出版信息

JMIR Mhealth Uhealth. 2020 Oct 28;8(10):e17470. doi: 10.2196/17470.

Abstract

BACKGROUND

Worldwide, hypertension control rates remain suboptimal despite clinically effective antihypertensive drug therapy. Patient failure to take medication as prescribed (ie, nonadherence) is the most important factor contributing to poor control. Smartphone apps can facilitate the delivery of evidence-based behavior change techniques to improve adherence and may provide a scalable, usable, and feasible method to deliver self-management support.

OBJECTIVE

The aim of this study is to explore patients' experiences of the usability and feasibility of smartphone apps to support self-management and improve medication adherence in hypertension.

METHODS

A qualitative descriptive study was conducted. A total of 11 people living with hypertension from the West of Ireland were sampled purposively and interviewed about their experience of using a self-management app for a 4-week period, which included two key functionalities: self-monitoring of blood pressure (BP) and medication reminders. Thematic analysis was carried out on the semistructured interview data.

RESULTS

Participants' age ranged from 43 to 74 years (mean 62 years, SD 9.13). Three themes were identified: digital empowerment of self-management, human versus digital systems, and digital sustainability. Although patients' experience of using the technology to self-monitor BP was one of empowerment, characterized by an enhanced insight and understanding into their condition, control, and personal responsibility, the reminder function was only feasible for patients who reported unintentional nonadherence to treatment. Patients experienced the app as a sustainable tool to support self-management and found it easy to use, including those with limited technological competence.

CONCLUSIONS

The study's findings provide new insights into the experience of using apps to support medication adherence in hypertension. Overall, the data support apps as a usable and feasible method to aid self-management of hypertension and highlight the need for personalized functionality, particularly with regard to medication adherence reminder strategies. The study's findings challenge the perspective that the use of these technologies to support self-management can inevitably add to the burden of treatment experienced by patients.

摘要

背景

尽管降压药物治疗具有临床疗效,但全球范围内高血压的控制率仍不理想。患者未按规定服药(即不依从)是导致控制不佳的最重要因素。智能手机应用程序可以促进提供基于证据的行为改变技术以提高依从性,并且可能为提供自我管理支持提供一种可扩展、可用且可行的方法。

目的

本研究旨在探讨患者对支持自我管理和改善高血压药物依从性的智能手机应用程序的可用性和可行性的体验。

方法

进行了定性描述性研究。从爱尔兰西部有高血压的 11 人进行了有针对性的抽样,并对他们在 4 周内使用自我管理应用程序的经验进行了访谈,其中包括两个关键功能:血压(BP)自我监测和药物提醒。对半结构化访谈数据进行了主题分析。

结果

参与者的年龄从 43 岁到 74 岁(平均 62 岁,SD 9.13)。确定了三个主题:自我管理的数字化授权、人与数字系统以及数字化可持续性。尽管患者使用该技术自我监测 BP 的体验是一种赋权体验,其特点是对自己的病情、控制和个人责任有了更深入的了解和理解,但提醒功能仅对报告非故意不遵医嘱的患者可行。患者将该应用程序体验为支持自我管理的可持续工具,发现其易于使用,包括那些技术能力有限的患者。

结论

该研究的结果提供了使用应用程序支持高血压药物依从性的新见解。总体而言,数据支持将应用程序作为辅助高血压自我管理的一种可用且可行的方法,并强调需要个性化功能,特别是在药物依从性提醒策略方面。研究结果挑战了这样一种观点,即使用这些技术支持自我管理不可避免地会增加患者治疗的负担。

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