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癌症患者出院后自我报告用药安全事件的数字技术接受和使用情况:调查研究。

The Acceptance and Use of Digital Technologies for Self-Reporting Medication Safety Events After Care Transitions to Home in Patients With Cancer: Survey Study.

机构信息

School of Nursing, University of Michigan, Ann Arbor, MI, United States.

Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States.

出版信息

J Med Internet Res. 2024 Mar 8;26:e47685. doi: 10.2196/47685.

Abstract

BACKGROUND

Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in adopting digital technologies and engaging in self-reporting medication safety events during transitions of care have not been fully understood.

OBJECTIVE

We aim to assess oncology patients' perceptions of medication and communication safety during care transitions and their willingness to use digital technologies for self-reporting medication safety events and to identify factors associated with their technology acceptance.

METHODS

A cross-sectional survey study was conducted with adult patients with breast, prostate, lung, or colorectal cancer (N=204) who had experienced care transitions from hospitals or clinics to home in the past 1 year. Surveys were conducted via phone, the internet, or email between December 2021 and August 2022. Participants' perceptions of medication and communication safety and perceived usefulness, ease of use, attitude toward use, and intention to use a technology system to report their medication safety events from home were assessed as outcomes. Potential personal, clinical, and psychosocial factors were analyzed for their associations with participants' technology acceptance through bivariate correlation analyses and multiple logistic regressions.

RESULTS

Participants reported strong perceptions of medication and communication safety, positively correlated with medication self-management ability and patient activation. Although most participants perceived a medication safety self-reporting system as useful (158/204, 77.5%) and easy to use (157/204, 77%), had a positive attitude toward use (162/204, 79.4%), and were willing to use such a system (129/204, 63.2%), their technology acceptance was associated with their activation levels (odds ratio [OR] 1.83, 95% CI 1.12-2.98), their perceptions of communication safety (OR 1.64, 95% CI 1.08-2.47), and whether they could receive feedback after self-reporting (OR 3.27, 95% CI 1.37-7.78).

CONCLUSIONS

In general, oncology patients were willing to use digital technologies to report their medication events after care transitions back home because of their high concerns regarding medication safety. As informed and activated patients are more likely to have the knowledge and capability to initiate and engage in self-reporting, developing a patient-centered reporting system to empower patients and their families and facilitate safety health communications will help oncology patients in addressing their medication safety concerns, meeting their care needs, and holding promise to improve the quality of cancer care.

摘要

背景

在患者过渡期间,积极让癌症患者及其家属参与监测和报告用药安全事件,对于实现最佳患者安全结果是不可或缺的。然而,现有的患者自我报告系统往往无法解决患者在用药安全方面的各种体验和担忧。此外,这些系统通常不是为患者的即时报告而设计的。由于缺乏患者对用药安全自我监测和报告的参与,患者在过渡回家后对用药安全事件的性质、范围和原因的了解存在显著的知识空白。癌症患者在采用数字技术和参与过渡期间用药安全自我报告方面的挑战尚未得到充分理解。

目的

我们旨在评估肿瘤患者在过渡期间对用药和沟通安全的看法,以及他们使用数字技术自我报告用药安全事件的意愿,并确定与他们的技术接受度相关的因素。

方法

对 204 名在过去 1 年内经历过从医院或诊所过渡回家的乳腺癌、前列腺癌、肺癌或结直肠癌患者进行了横断面调查研究。调查于 2021 年 12 月至 2022 年 8 月期间通过电话、互联网或电子邮件进行。评估参与者对用药和沟通安全的看法以及对自我报告用药安全事件的技术系统的感知有用性、易用性、使用态度和使用意愿作为结果。通过单变量相关分析和多变量逻辑回归分析,分析潜在的个人、临床和心理社会因素与参与者技术接受度的关系。

结果

参与者报告了对用药和沟通安全的强烈感知,与用药自我管理能力和患者激活呈正相关。尽管大多数参与者认为用药安全自我报告系统有用(158/204,77.5%)和易用(157/204,77.0%),对使用持积极态度(162/204,79.4%),愿意使用这样的系统(129/204,63.2%),但他们的技术接受度与他们的激活水平(比值比[OR]1.83,95%置信区间[CI]1.12-2.98)、对沟通安全的感知(OR 1.64,95%CI 1.08-2.47)以及他们是否能够在自我报告后收到反馈(OR 3.27,95%CI 1.37-7.78)相关。

结论

总的来说,肿瘤患者愿意在过渡回家后使用数字技术报告他们的用药事件,因为他们对用药安全高度关注。由于知情和激活的患者更有可能具备启动和参与自我报告的知识和能力,因此开发以患者为中心的报告系统,赋予患者及其家属权力并促进安全的健康沟通,将有助于肿瘤患者解决他们的用药安全问题,满足他们的护理需求,并有望提高癌症护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3f/10960221/1e4720fd206d/jmir_v26i1e47685_fig1.jpg

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