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The effect of reminder systems on patients' adherence to treatment

机译：提醒系统对患者坚持治疗的影响

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Background: Patient adherence is an important component of the treatment of chronic disease. An understanding of patient adherence and its modulating factors is necessary to correctly interpret treatment efficacy and barriers to therapeutic success.Purpose: This meta-analysis aims to systematically review published randomized controlled trials of reminder interventions to assist patient adherence to prescribed medications.Methods: A Medline search was performed for randomized controlled trials published between 1968 and June 2011, which studied the effect of reminder-based interventions on adherence to self-administered daily medications.Results: Eleven published randomized controlled trials were found between 1999 and 2009 which measured adherence to a daily medication in a group receiving reminder interventions compared to controls receiving no reminders. Medication adherence was measured as the number of doses taken compared to the number prescribed within a set period of time. Meta-analysis showed a statistically significant increase in adherence in groups receiving a reminder intervention compared to controls (66.61% versus 54.71%, 95% CI for mean: 0.8% to 22.4%). Self-reported and electronically monitored adherence rates did not significantly differ (68.04% versus 63.67%, P = 1.0). Eight of eleven studies showed a statistically significant increase in adherence for at least one of the reminder group arms compared to the control groups receiving no reminder intervention.Limitations: The data are limited by imperfect measures of adherence due to variability in data collection methods. It is also likely that concomitant educational efforts in the study populations, such as instructions regarding proper administration and importance of correct dosing schedules, contributed to improved patient adherence, both in reminder and control arms. The search strategy could have missed relevant studies which were categorized by disease rather than adherence.Conclusions: Reminder-based interventions may improve adherence to daily medications. However, the interventions used in these studies, which included reminder phone calls, text messages, pagers, interactive voice response systems, videotelephone calls, and programmed electronic audiovisual reminder devices, are impractical for widespread implementation, and their efficacy may be optimized when combined with alternative adherence-modifying strategies. More practical reminder-based interventions should be assessed to determine their value in improving patient adherence and treatment outcomes.
机译：背景：患者的依从性是治疗慢性疾病的重要组成部分。目的：本荟萃分析旨在系统地审查已发表的提醒干预措施的随机对照试验，以帮助患者坚持处方药，以了解患者依从性及其调节因素，以正确解释治疗效果和成功治疗的障碍。 Medline搜索了1968年至2011年6月间发表的随机对照试验，研究了基于提醒的干预措施对坚持每日服用自用药物的影响。结果：1999年至2009年之间发现了11项公开的随机对照试验，这些试验测量了依从性与未收到提醒的对照组相比，接受提醒干预的组中的每日用药。药物依从性的衡量标准是在设定的时间段内所服用的剂量与规定的剂量相比。荟萃分析显示，与对照组相比，接受提醒干预的组的依从性有统计学意义的提高（66.61％比54.71％，平均95％CI：0.8％至22.4％）。自我报告和电子监测的依从率没有显着差异（68.04％对63.67％，P = 1.0）。十一项研究中的八项研究显示，与未接受提醒干预的对照组相比，提醒组中至少一个提醒组的依从性有统计学上的显着提高。在研究人群中伴随进行的教育工作（例如有关正确给药的说明和正确用药时间表的重要性）也可能有助于提高患者在催促和控制方面的依从性。该搜索策略可能会错过按疾病而不是依从性分类的相关研究。结论：基于提醒的干预措施可能会改善对日常药物的依从性。但是，这些研究中使用的干预措施（包括提醒电话，短信，寻呼机，交互式语音应答系统，视频电话和已编程的电子视听提醒设备）对于广泛实施是不切实际的，并且当与替代性的修改依从性策略。应该评估更实用的基于提醒的干预措施，以确定其在改善患者依从性和治疗效果方面的价值。

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