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首页> 外文期刊>JAMA ophthalmology >Automated telecommunication-based reminders and adherence with once-daily glaucoma medication dosing: The automated dosing reminder study
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Automated telecommunication-based reminders and adherence with once-daily glaucoma medication dosing: The automated dosing reminder study

机译：基于电信的自动提醒和每天一次青光眼药物剂量的依从性：自动剂量提醒研究

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IMPORTANCE: Topical glaucoma medications lower intraocular pressure and alter the course of the disease. Because adherence with glaucoma medications is a known problem, interventions are needed to help those patients who do not take their medications as prescribed. OBJECTIVE: To assess the ability of an automated telecommunication-based intervention to improve adherence with glaucoma medications. DESIGN, SETTING, AND PARTICIPANTS: We performed a prospective cohort study of medication adherence, followed by a randomized intervention for those found to be nonadherent, of individuals recruited from a university-based glaucoma subspecialty clinic. A total of 491 participants were enrolled in the initial assessment of adherence. Of those, 70 were nonadherent with their medications after 3 months of electronic monitoring and randomized to intervention and control groups. INTERVENTIONS: A personal health record was used to store the list of patient medications and reminder preferences. On the basis of those data, participants randomized to the intervention received daily messages, either text or voice, reminding them to take their medication. Participants randomized to the control group received usual care. MAIN OUTCOMES AND MEASURES: Difference in adherence before and after initiation of the intervention. RESULTS: Using an intent-to-treat analysis, we found that the median adherence rate in the 38 participants randomized to the intervention increased from 53% to 64% (P < .05). There was no statistical change in 32 participants in the control group. To assess the real efficacy of the intervention, the same comparison was performed for the participants who successfully completed the study after randomization. Analyzed this way, the adherence rate in the 20 participants in the intervention group increased from 54% to 73% (P < .05), whereas there was again no statistical change in the 19 participants in the control group. Eighty-four percent of the participants who received reminders agreed they were helpful and would continue using them outside the study. CONCLUSIONS AND RELEVANCE: Automated telecommunication-based reminders linked to data in a personal health record improved adherence with once-daily glaucoma medications. This is an effectivemethod to improve adherence that could realistically be implemented in ophthalmology practices with a minimum amount of effort on the part of the practice or the patient.
机译：重要提示：局部青光眼药物可降低眼内压并改变疾病进程。由于青光眼药物的依从性是一个已知问题，因此需要采取干预措施来帮助那些未按规定服用药物的患者。目的：评估基于电信的自动化干预措施改善青光眼药物依从性的能力。设计，地点和参与者：我们对前瞻性队列研究进行了药物依从性研究，然后对从大学青光眼专科诊所招募的个体进行随机干预，以发现不依从的患者。共有491名参与者参加了依从性的初步评估。其中有70名患者在进行3个月的电子监测后不服药，并随机分为干预组和对照组。干预措施：个人健康记录用于存储患者用药清单和提醒偏好。根据这些数据，参与者随机接受干预，每天收到短信或语音消息，提醒他们服用药物。随机分为对照组的参与者接受常规护理。主要结果和措施：干预开始前后依从性的差异。结果：使用意向治疗分析，我们发现随机分配给干预措施的38名参与者的中位依从率从53％增加到64％（P <.05）。对照组的32名参与者没有统计学变化。为了评估干预的实际效果，对在随机分组后成功完成研究的参与者进行了相同的比较。通过这种方式进行分析，干预组的20名参与者的依从率从54％增加到73％（P <.05），而对照组的19名参与者再次没有统计学变化。收到提醒的参与者中有84％同意他们的帮助，并且会在研究之外继续使用它们。结论和相关性：与个人健康记录中的数据相关的基于电信的自动提醒功能提高了每日一次青光眼药物的依从性。这是一种改善依从性的有效方法，可以在眼科实践中以最少的实践或患者的努力来实际实施。

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