Pardee RAND Graduate School, Santa Monica, California, USA
RAND Corporation, Santa Monica, California, USA.
BMJ Open. 2024 Jul 11;14(7):e079401. doi: 10.1136/bmjopen-2023-079401.
The aim of this study was to a) explore barriers and facilitators associated with medication-taking habit formation, and b) elicit feedback on the components of an intervention designed to help form strong habits for long-term medication adherence.
The study design was qualitative; we conducted semistructured interviews between September 2021 and February 2022.
The interviews were conducted online, with 27 participants recruited at the Cedars-Sinai Medical Center in Los Angeles, California.
A purposive sample of 20 patients who were over 18 years of age, had been diagnosed with hypertensive disorder (or reported high blood pressure; >140/90 mm Hg) and who were prescribed antihypertensive therapy at the time of recruitment, along with seven providers were interviewed.
Contextual factors included frequent changes to prescription for regimen adjustment, and polypharmacy. Forgetfulness, perceived need for medication, and routine disruptions were identified as possible barriers to habit formation. Facilitators of habit formation included identification of stable routines for anchoring, planning, use of external reminders (including visual reminders) and pillboxes for prescription management, and extrinsic motivation for forming habits. Interestingly, experiencing medication side effects was identified as a possible barrier and a possible facilitator of habit formation. Feedback on study components included increasing text size, and visual appeal of the habit leaflet; and imparting variation in text message content and adjusting their frequency to once a day. Patients generally favoured the use of conditional financial incentives to support habit formation.
The study sheds light on some key considerations concerning the contextual factors for habit formation among people with hypertension. As such, future studies may evaluate the generalisability of our findings, consider the role of visual reminders in habit formation and sustenance, and explore possible disruptions to habits.
NCT04029883.
本研究旨在：(a) 探索与形成服药习惯相关的障碍和促进因素；(b) 就旨在帮助形成长期服药习惯的干预措施的组成部分征求反馈意见。
研究设计为定性；我们于 2021 年 9 月至 2022 年 2 月期间进行了半结构式访谈。
访谈在线进行，参与者在加利福尼亚州洛杉矶的雪松西奈医疗中心招募，共有 27 名参与者，包括 20 名年龄在 18 岁以上的患者和 7 名医护人员。
我们招募了 20 名患者，他们的诊断为高血压疾病（或报告血压升高；>140/90mmHg），在招募时正在服用降压药物，以及 7 名医护人员接受了采访。
背景因素包括频繁调整处方以调整治疗方案，以及多药治疗。健忘、认为需要服药以及日常生活中断被认为是形成习惯的障碍。促进习惯形成的因素包括确定稳定的常规来锚定、计划、使用外部提醒（包括视觉提醒）和药盒来管理处方以及形成习惯的外在动机。有趣的是，出现药物副作用被认为是形成习惯的障碍和促进因素。对研究组成部分的反馈包括增加文本大小和习惯传单的视觉吸引力；并改变短信内容的变化和调整其频率为每天一次。患者普遍赞成使用有条件的经济激励来支持习惯形成。
该研究揭示了一些关于高血压患者形成习惯的背景因素的关键考虑因素。因此，未来的研究可能会评估我们研究结果的普遍性，考虑视觉提醒在习惯形成和维持中的作用，并探索习惯可能被打破的情况。
NCT04029883。
