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提高 HIV 感染者的生活质量和药物依从性:信息系统的影响。

Enhancing quality of life and medication adherence for people living with HIV: the impact of an information system.

机构信息

Ph.D. Programme Health Management, Frederick University, Nicosia, Cyprus.

Gregorios AIDS Clinic, General Hospital of Larnaca, Larnaca, Cyprus.

出版信息

J Patient Rep Outcomes. 2024 Jan 23;8(1):10. doi: 10.1186/s41687-023-00680-x.

Abstract

BACKGROUND

The widespread availability of antiretroviral therapy has led to improvements in life expectancy and thus an increase in the number of people living with HIV/AIDS (PLWHA) worldwide. However, a similar increase in the number of newly-diagnosed patients in Cyprus suggests the need for solutions designed to improve monitoring, planning, and patient communication. In this study, we aimed to determine whether the use of an information system to manage PLWHA might contribute to improved quality of life and critical adherence to prescribed drug regimens and ongoing medical care.

METHODS

A randomized controlled trial study was conducted in Cyprus based on information that we collected using the highly valid and reliable Greek translation of the World Health Organization (WHO) Quality of Life (QOL) HIV-BREF questionnaire to assess sociodemographic variables and patient compliance. We distributed 200 questionnaires before implementing a Health Medical Care (HMC) information system at our clinic. Six months after implementing this system, 68 of the completed questionnaires were selected, including two groups of 34 participants who had been assigned at random to the intervention or the control group. Participants included PLWHA aged ≥ 18 years who had been receiving antiretroviral therapy for more than 12 months between July 15, 2020, and July 15, 2022.

RESULTS

The changes in baseline to six-month scores reported for the intervention group were significantly higher than in the control group in all six subscales assessed with the WHOQOL-HIV-BREF questionnaire, as well as in the assessment of compliance. Furthermore, compliance with treatment was associated with higher scores in the questionnaire subscales, including physical health, psychological health, degree of autonomy, social relationships, life circumstances, and spirituality/religious/personal beliefs. We also identified specific demographic factors and behaviors that were associated with better compliance with scheduled medical care and the prescribed drug regimen. Specifically, men exhibited better compliance than women and younger PLWHA exhibited better compliance than the elderly as did individuals who reported a higher level of educational attainment. Additionally, individuals who did not use addictive substances, consumed less alcohol, and were managed using the monitoring information system all exhibited better compliance compared to those in the control group.

CONCLUSION

The results of this study suggest that management of PLWHA via the use of an information system can contribute to improved QOL and drug compliance.

摘要

背景

抗逆转录病毒疗法的广泛应用提高了预期寿命,从而导致全球范围内艾滋病毒/艾滋病(PLWHA)患者数量的增加。然而,塞浦路斯新诊断患者数量的类似增加表明需要设计解决方案,以改善监测、规划和患者沟通。在这项研究中,我们旨在确定使用信息系统来管理 PLWHA 是否有助于提高生活质量和关键药物方案的依从性以及持续的医疗护理。

方法

我们在塞浦路斯进行了一项随机对照试验研究,该研究基于我们使用高度有效和可靠的希腊文翻译版世界卫生组织(WHO)生活质量(QOL)HIV-BREF 问卷收集的信息,以评估社会人口统计学变量和患者依从性。我们在诊所实施医疗保健信息系统之前分发了 200 份问卷。该系统实施六个月后,选择了 68 份完成的问卷,包括两组随机分配到干预组或对照组的 34 名参与者。参与者包括年龄≥18 岁的 PLWHA,他们在 2020 年 7 月 15 日至 2022 年 7 月 15 日期间接受了超过 12 个月的抗逆转录病毒治疗。

结果

与对照组相比,干预组在使用 WHOQOL-HIV-BREF 问卷评估的所有六个子量表以及在评估依从性方面,从基线到六个月的评分变化均显著更高。此外,治疗依从性与问卷子量表的更高分数相关,包括身体健康、心理健康、自主程度、社会关系、生活环境和精神/宗教/个人信仰。我们还确定了与更好地遵守计划中的医疗护理和规定的药物方案相关的特定人口统计学因素和行为。具体而言,男性比女性表现出更好的依从性,年轻的 PLWHA 比老年人表现出更好的依从性,而教育程度较高的人也是如此。此外,与对照组相比,不使用成瘾物质、饮酒较少且使用监测信息系统进行管理的个体表现出更好的依从性。

结论

这项研究的结果表明,通过使用信息系统管理 PLWHA 可以提高生活质量和药物依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23b/10805742/4075e17f88b9/41687_2023_680_Fig1_HTML.jpg

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