Assistant Professor, Southern Illinois University Edwardsville School of Nursing, Edwardsville, IL.
Professor, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
Nephrol Nurs J. 2021 Jul-Aug;48(4):389-417.
The SystemCHANGE™ intervention has led to great improvements in medication adherence, which is a challenge for nearly one-third of kidney transplant recipients. This secondary data analysis sought to measure the frequency of individual solutions utilized by participants in a previously conducted randomized controlled trial of the SystemCHANGE™ intervention and to determine which classes of solutions had greatest impact on improved medication adherence. Solutions that were significant predictors of improving medication adherence to the 85% or higher level included alarm cues (p ≤ 0.0001), time cues (p = 0.006), restructuring the physical environment (p = 0.048), and social support (p = 0.023). Alarm and time cues, restructuring the environment, and social support were successful solutions largely influenced by personal routine and environment consideration that might be prioritized in future studies when implementing SystemCHANGE™.
SystemCHANGE™干预措施显著提高了药物依从性，而近三分之一的肾移植受者都面临着这一挑战。本二次数据分析旨在衡量 SystemCHANGE™干预措施的先前随机对照试验中参与者所采用的个别解决方案的频率，并确定对改善药物依从性影响最大的解决方案类别。对提高药物依从性至 85%或更高水平有显著预测作用的解决方案包括报警提示（p≤0.0001）、时间提示（p=0.006）、重构物理环境（p=0.048）和社会支持（p=0.023）。报警提示和时间提示、重构环境以及社会支持是成功的解决方案，这些方案主要受到个人日常习惯和环境因素的影响，在未来实施 SystemCHANGE™的研究中，可能会优先考虑这些因素。
