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NPS MedicineWise 手机应用程序支持慢性心力衰竭患者药物依从性的可接受性和可行性:一项试点研究方案。

Acceptability and feasibility of the NPS MedicineWise mobile phone application in supporting medication adherence in patients with chronic heart failure: Protocol for a pilot study.

机构信息

Clinical and Health Sciences, University of South Australia, Adelaide, Australia.

Consumer Medicines Information Services, NPS Medicine Wise, Sydney, Australia.

出版信息

PLoS One. 2022 Feb 4;17(2):e0263284. doi: 10.1371/journal.pone.0263284. eCollection 2022.

Abstract

INTRODUCTION

Heart failure (HF) is an increasing global concern. Despite evidence-based pharmacotherapy, morbidity and mortality remain high in HF. Medication non-adherence is a crucial factor in optimising clinical outcomes. A growing number of smartphone applications (apps) assist management. While evidence support their use to promote treatment adherence, apps alone may not be the solution. The objective of this pilot study is to assess the acceptability and feasibility of a tiered intervention added to the NPS MedicineWise dose reminder app (MedicineWise app) in supporting medication adherence in HF.

METHODS AND ANALYSIS

This prospective, single-blinded, randomised controlled trial will recruit 55 Australian patients with HF to be randomly assigned to either intervention (MedicineWise app + usual care) or control (usual care alone) arm. Control participants will remain unaware of the intervention throughout the study. At baseline, intervention participants will be instructed in the MedicineWise app. A reminder will then prompt medication administration at each dosing interval. If non-adherence is suggested from 24 hourly reports (critical medications) or 72 hours (non-critical medications), the individual/s will be escalated through a tiered, pharmacist-led intervention. The primary outcome will be the acceptability and feasibility of this approach in supporting adherence. Between-group comparison of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) at baseline, 3 and 6 months will be used to measure the app's value in supporting adherence. Secondary outcome measures include self-reported medication adherence and knowledge, health-related quality of life, psychological wellbeing, signs and symptoms of HF, and medication and HF knowledge.

ETHICS AND DISSEMINATION

The protocol received ethics approval from Central Adelaide Clinical Human Research Ethics Committee (Protocol number R20190302) and University of South Australia Human Research Ethics Committee (Protocol number 202450). Findings will be disseminated through peer-reviewed journals.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry Clinical trial number: ACTRN12619000289112p (http://www.ANZCTR.org.au/ACTRN12619000289112p.aspx).

摘要

引言

心力衰竭(HF)是一个日益严重的全球性问题。尽管有循证药物治疗,但 HF 患者的发病率和死亡率仍然很高。药物依从性差是优化临床结局的关键因素。越来越多的智能手机应用程序(apps)有助于管理。虽然有证据支持使用这些应用程序来促进治疗依从性,但仅凭应用程序可能不是解决方案。本研究的目的是评估在 NPS 医学智慧剂量提醒应用程序(医学智慧应用程序)中添加分层干预措施以支持 HF 患者药物依从性的可接受性和可行性。

方法和分析

这是一项前瞻性、单盲、随机对照试验,将招募 55 名澳大利亚 HF 患者,随机分为干预组(医学智慧应用程序+常规护理)或对照组(仅常规护理)。对照组在整个研究过程中都不知道干预措施。在基线时,干预组将接受医学智慧应用程序的指导。然后,提醒将在每个剂量间隔时提示药物管理。如果 24 小时报告(关键药物)或 72 小时(非关键药物)提示药物不依从,则个人/将通过分层、药剂师主导的干预措施升级。主要结果将是支持依从性的这种方法的可接受性和可行性。在基线、3 个月和 6 个月时使用自我评估适当药物使用量表(SEAMS)的组间比较来衡量该应用程序在支持依从性方面的价值。次要结局指标包括自我报告的药物依从性和知识、健康相关生活质量、心理健康、HF 体征和症状以及药物和 HF 知识。

伦理和传播

该方案已获得中央阿德莱德临床人类研究伦理委员会(方案编号 R20190302)和南澳大利亚大学人类研究伦理委员会(方案编号 202450)的批准。研究结果将通过同行评议的期刊发表。

试验注册

澳大利亚和新西兰临床试验注册临床试验编号:ACTRN12619000289112p(http://www.ANZCTR.org.au/ACTRN12619000289112p.aspx)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0339/8815969/a8a258d43f1e/pone.0263284.g001.jpg

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