@文章{信息:doi/10.2196/13259，作者=“Ware, Patrick and Dorai, Mala and Ross, Heather J and Cafazzo, Joseph A and Laporte, Audrey and Boodoo, Chris and Seto, Emily”，标题=“患者对基于手机的心力衰竭远程监测方案的坚持:一项纵向混合方法研究”，期刊=“JMIR Mhealth Uhealth”，年=“2019”，月=“Feb”，日=“26”，卷=“7”，数=“2”，页=“e13259”，关键词=“远程监测;移动健康;依从性;背景:远程监护(TM)可以通过促进患者自我护理和临床决策支持来改善心力衰竭(HF)的预后。然而，这些结果只有在患者始终坚持进行规定的家庭读数时才有可能实现。目的:本研究的目的是:(1)量化患者在基于手机的TM项目背景下坚持进行规定的家庭读数的程度;(2)根据项目注册的持续时间、患者特征和患者对TM项目的看法来解释纵向依从率。方法:采用混合方法解释序列设计，以技术接受与使用统一理论2 (UTAUT2)为解释方法指导。总体依从率计算为患者测量体重、血压、心率和症状读数的天数占他们参加该计划长达1年的总天数的比例。每月依从率也被计算为患者在项目登记后的每30天内进行相同4次读数的天数比例。接下来，进行简单和多变量回归，以确定时间、年龄、性别和疾病严重程度对依从率的影响。 Additional explanatory methods included questionnaires at 6 and 12 months probing patients on the perceived benefits and ease of use of the TM program, an analysis of reasons for patients leaving the program, and semistructured interviews conducted with a purposeful sampling of patients (n=24) with a range of adherence rates and demographics. Results: Overall average adherence was 73.6{\%} (SD 25.0) with average adherence rates declining over time at a rate of 1.4{\%} per month (P<.001). The multivariate regressions found no significant effect of sex and disease severity on adherence rates. When grouping patients' ages by decade, age was a significant predictor (P=.04) whereby older patients had higher adherence rates over time. Adherence rates were further explained by patients' perceptions with regard to the themes of (1) performance expectancy (improvements in HF management and peace of mind), (2) effort expectancy (ease of use and technical issues), (3) facilitating conditions (availability of technical support and automated adherence calls), (4) social influence (support from family, friends, and trusted clinicians), and (5) habit (degree to which taking readings became automatic). Conclusions: The decline in adherence rates over time is consistent with findings from other studies. However, this study also found adherence to be the highest and most consistent over time in older age groups and progressively lower over time for younger age groups. These findings can inform the design and implementation of TM interventions that maximize patient adherence, which will enable a more accurate evaluation of impact and optimization of resources. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.9911 ", issn="2291-5222", doi="10.2196/13259", url="http://mhealth.www.mybigtv.com/2019/2/e13259/", url="https://doi.org/10.2196/13259", url="http://www.ncbi.nlm.nih.gov/pubmed/30806625" }