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手机辅助改善慢性病青少年和青年成人用药依从性的随机试点试验。

Randomized pilot trial of cell phone support to improve medication adherence among adolescents and young adults with chronic health conditions.

作者信息

Sayegh Caitlin S, MacDonell Karen K, Iverson Ellen, Beard Breaon, Chang Nancy, Vu My H, Belzer Marvin

机构信息

Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd., MS#2, Los Angeles, CA 90027, USA.

Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, USA.

出版信息

BMC Digit Health. 2024;2(1). doi: 10.1186/s44247-024-00069-w. Epub 2024 Mar 19.

Abstract

INTRODUCTION

Adolescents and young adults (AYA) living with chronic medical conditions often struggle to develop medication adherence skills. This pilot trial evaluated the impact of a mobile health coaching intervention, Cell Phone Support (CPS), on medication adherence.

METHODS

Interventions in this randomized trial were CPS delivered by phone calls (CPS-C), CPS delivered by text messages (CPS-T), or automated text message reminders (ATR). Participants were AYA with different chronic medical conditions (i.e., sickle cell disease, solid organ transplant, type 2 diabetes), aged 15-20 years ( = 34). We examined the feasibility, acceptability, and preliminary efficacy of each intervention.

RESULTS

We examined the feasibility, acceptability, and preliminary efficacy of both CPS interventions. CPS was feasible and acceptable. There was evidence that participants found CPS to be more useful than ATR. In this pilot trial, participants receiving CPS reported relatively stronger increases in adherence, compared to those assigned to ATR. CPS-C slightly outperformed CPS-T.

CONCLUSIONS

Providing coaching to AYA struggling with illness self-management via their cell phones may promote their acquisition of medication adherence skills. Although larger studies are needed to confirm the results of this pilot study, phone calls and text messages are both promising modalities for delivering human cell phone support.

TRIAL REGISTRATION

This trial was registered prospectively at ClinicalTrials.gov (NCT04241627) on 1/27/2020.

摘要

引言

患有慢性疾病的青少年和青年(AYA)往往难以掌握药物依从性技能。这项试点试验评估了移动健康指导干预措施“手机支持(CPS)”对药物依从性的影响。

方法

在这项随机试验中,干预措施包括通过电话提供的CPS(CPS-C)、通过短信提供的CPS(CPS-T)或自动短信提醒(ATR)。参与者为年龄在15至20岁之间(n = 34)、患有不同慢性疾病(即镰状细胞病、实体器官移植、2型糖尿病)的AYA。我们研究了每种干预措施的可行性、可接受性和初步疗效。

结果

我们研究了两种CPS干预措施的可行性、可接受性和初步疗效。CPS是可行且可接受的。有证据表明,参与者发现CPS比ATR更有用。在这项试点试验中,与分配到ATR的参与者相比,接受CPS的参与者报告的依从性提高相对更强。CPS-C略优于CPS-T。

结论

通过手机为在疾病自我管理方面存在困难的AYA提供指导,可能会促进他们掌握药物依从性技能。尽管需要更大规模的研究来证实这项试点研究的结果,但电话和短信都是提供人力手机支持的有前景的方式。

试验注册

该试验于2020年1月27日在ClinicalTrials.gov(NCT04241627)上进行了前瞻性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbe1/11360945/88ce73a3d115/nihms-2018084-f0001.jpg

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