Y. Emad, MA, K.J. Petrie, PhD, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand;
N. Dalbeth, MD, Department of Medicine, University of Auckland, Auckland, New Zealand.
J Rheumatol. 2024 Feb 1;51(2):189-196. doi: 10.3899/jrheum.2023-0711.
This feasibility study aimed to assess the acceptability of using smartphone notifications to modify the medication beliefs of people with gout. We evaluated the feasibility and acceptability of a smartphone application using the Technology Acceptance Model. We explored adherence rate differences and outcomes between the intervention and control groups.
Fifty-two patients with gout who were prescribed allopurinol were randomly assigned to either active control (n = 24) or intervention group (n = 28). Over 3 months, both groups used the study app on their smartphones. The active control group received notifications about general health advice, whereas the intervention group received adherence-targeted notifications. The feasibility and acceptability of the smartphone app was measured through semistructured interviews. Adherence rate was assessed through serum urate levels and missed doses at 3 timepoints: baseline, 3 months (post intervention), and 6 months (follow-up).
The smartphone app demonstrated high feasibility, with strong participant retention and compliance. The participants expressed high levels of satisfaction with the app's user-friendliness and content, highlighting its acceptability. Both groups showed a significant reduction in missed doses over time ( < 0.05), but no significant differences in serum urate levels were found between the groups. Patients who received adherence-targeted notifications reported finding it more convenient to take allopurinol and expressed higher overall treatment satisfaction throughout the study.
Adherence-targeted notifications have the potential to be an effective and scalable approach to supporting medication adherence in patients with gout. Further research is needed with larger samples to refine the components of the intervention and explore its optimal implementation.
本可行性研究旨在评估使用智能手机通知来改变痛风患者药物信念的可接受性。我们使用技术接受模型评估了智能手机应用程序的可行性和可接受性。我们探讨了干预组和对照组之间的遵医嘱率差异和结果。
52 名被处方别嘌醇的痛风患者被随机分为主动对照组（n = 24）和干预组（n = 28）。在 3 个月的时间里，两组患者均在智能手机上使用研究应用程序。主动对照组收到有关一般健康建议的通知，而干预组则收到遵医嘱通知。通过半结构化访谈来评估智能手机应用程序的可行性和可接受性。通过血清尿酸水平和 3 个时间点（基线、3 个月（干预后）和 6 个月（随访））的漏服剂量来评估遵医嘱率。
智能手机应用程序表现出很高的可行性，参与者保留率和依从性都很强。参与者对应用程序的用户友好性和内容表示出高度满意，突出了其可接受性。随着时间的推移，两组的漏服剂量都显著减少（<0.05），但两组的血清尿酸水平没有显著差异。接受遵医嘱通知的患者表示服用别嘌醇更方便，并且在整个研究过程中表达了更高的总体治疗满意度。
针对遵医嘱的通知有可能成为支持痛风患者药物依从性的一种有效且可扩展的方法。需要进一步研究，以扩大样本量，完善干预措施的组成部分，并探索其最佳实施方式。
