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电子健康策略改善心血管代谢疾病患者的药物依从性:现状与未来方向。

Electronic health strategies to improve medication adherence in patients with cardiometabolic disease: current status and future directions.

机构信息

Department of Medicine, Tulane University School of Medicine.

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine.

出版信息

Curr Opin Cardiol. 2022 Jul 1;37(4):307-316. doi: 10.1097/HCO.0000000000000971.

Abstract

PURPOSE OF REVIEW

Enabled by widespread technological advancements, electronic health (eHealth) strategies have expanded rapidly over the last decade, presenting opportunities to support self-management including medication adherence for cardiometabolic disease control. eHealth can minimize access barriers to medications, enable timely assessment and shared decision-making, and provide medication reminders and health data feedback. This review summarizes current evidence for effectiveness of eHealth strategies for improving medication adherence in patients with hypertension, type 2 diabetes, and/or hyperlipidemia, and identifies priorities for future research.

RECENT FINDINGS

Current research supports the effectiveness of eHealth strategies to improve medication adherence and clinical outcomes for cardiometabolic disease. Although patient acceptability of eHealth strategies is generally high, engagement may decline over time. In addition, differences in effectiveness across intervention characteristics and sociodemographic groups are understudied, limiting generalizability and tailoring of interventions to local health system resources, culture, and patient needs or preferences.

SUMMARY

eHealth is a promising tool for addressing low medication adherence. Further work incorporating rigorous evaluation, assessment of patient engagement over time and effectiveness of intervention characteristics and components, and a health equity lens addressing eHealth use in vulnerable groups will increase understanding of the full potential of eHealth for improving medication adherence in diverse patients with cardiometabolic disease.

摘要

目的综述

在广泛的技术进步的推动下,电子健康 (eHealth) 策略在过去十年中迅速发展,为支持自我管理(包括心血管代谢疾病控制的药物依从性)提供了机会。eHealth 可以最小化药物获取障碍,实现及时评估和共同决策,并提供药物提醒和健康数据反馈。本文总结了当前 eHealth 策略在提高高血压、2 型糖尿病和/或血脂异常患者药物依从性方面的有效性证据,并确定了未来研究的重点。

最新发现

目前的研究支持 eHealth 策略在改善心血管代谢疾病的药物依从性和临床结果方面的有效性。尽管患者对 eHealth 策略的接受度普遍较高,但随着时间的推移,参与度可能会下降。此外,干预特征和社会人口学群体之间的有效性差异研究不足,限制了干预措施的普遍性和针对当地卫生系统资源、文化以及患者需求或偏好的针对性。

总结

eHealth 是解决低药物依从性的有前途的工具。进一步的工作包括严格评估、评估患者随时间的参与度以及干预特征和组成部分的有效性,并从健康公平的角度出发,解决弱势人群使用 eHealth 的问题,将增加对 eHealth 改善心血管代谢疾病患者药物依从性的全部潜力的理解。

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