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数字通信技术:为持续哮喘人群提供多种模式选择是否能提高用药依从性和结局?

Digital Communication Technology: Does Offering a Choice of Modality Improve Medication Adherence and Outcomes in a Persistent Asthma Population?

机构信息

Institute for Health Research, Kaiser Permanente Colorado, Denver, CO.

Department of Asthma, Allergy and Immunology, Colorado Permanente Medical Group, Denver, CO.

出版信息

Perm J. 2020 Dec;25:1. doi: 10.7812/TPP/20.189.

Abstract

BACKGROUND

Use of digital communication technology has shown potential to improve asthma adherence and outcomes. Few studies have looked at patient preference around mode of medication reminders used to improve and maintain asthma medication adherence.

OBJECTIVE

To determine if, in a population already receiving automated medication reminders, offering a choice for preferred mode of reminder (text, email, phone) would improve their adherence and asthma outcomes over a 1-year period.

METHODS

This was a pragmatic, randomized controlled trial conducted at Kaiser Permanente Colorado involving 7522 adult patients with persistent asthma. Study patients were randomized to receive usual care or their choice of medication reminder. Differences between the 2 groups in both medication adherence and asthma outcomes were then assessed over the following year.

RESULTS

Only 30% of those offered a choice of medication reminder modality responded by making a choice, with 52% preferring text messaging. There was less of a decrease in adherence rate over the 1-year period in those who made a choice regarding the mode of medication refill reminder. There was no difference in asthma outcomes between those who did make a choice compared with those who did not make a choice regarding the mode of medication refill reminder.

CONCLUSION

In a patient population already receiving medication reminders, offering a choice about what type of technology-enabled asthma medication reminder patients wanted did not improve outcomes but did enable a subgroup to better maintain their medication adherence.

摘要

背景

使用数字通信技术已显示出改善哮喘依从性和结果的潜力。很少有研究关注患者对改善和维持哮喘药物依从性所用药物提醒方式的偏好。

目的

确定在已经接受自动药物提醒的人群中,提供选择首选提醒方式(短信、电子邮件、电话)是否会在 1 年内改善他们的依从性和哮喘结果。

方法

这是一项在 Kaiser Permanente Colorado 进行的实用、随机对照试验,涉及 7522 名患有持续性哮喘的成年患者。研究患者被随机分配接受常规护理或他们选择的药物提醒。然后在接下来的一年中评估两组在药物依从性和哮喘结果方面的差异。

结果

只有 30%的患者选择了药物提醒方式,其中 52%更喜欢短信。在做出选择的患者中,在 1 年内药物依从率下降幅度较小。对于药物补充提醒方式,做出选择的患者与未做出选择的患者在哮喘结果方面没有差异。

结论

在已经接受药物提醒的患者群体中,提供有关患者想要的哪种技术增强型哮喘药物提醒方式的选择并不会改善结果,但确实使亚组能够更好地维持药物依从性。

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