TY - JOUR AU - van Lieshout, Jan AU - Lacroix, Joyca AU - van Halteren, Aart AU - Teichert, Martina PY - 2022 DA - 2022/4/7 TI -以患者为中心的沟通,药剂师领导的基于web的服药坚持工具的有效性:聚类随机对照试验结果JO - J Med Internet Res SP - e16141 VL - 24is - 4kw -药物依从性KW -改善KW -干预KW -网络KW -定制干预KW -以患者为中心KW -障碍KW -初级保健KW -心血管疾病KW -糖尿病AB -背景:越来越多的人使用药物治疗慢性疾病;不坚持治疗很常见,导致疾病控制不良。一种基于网络的工具可以识别与相关的潜在个体障碍有关的不依从性风险增加,从而促进量身定制的干预措施和改善依从性。目的:本研究旨在评估一种新开发的工具的有效性,旨在提高药物依从性。方法:我们对开始服用心血管或口服降糖药物的患者进行了一组随机对照试验。参与者是从社区药店招募的。他们完成了一份在线问卷,其中包括对他们不坚持用药的风险和随后坚持用药的障碍的评估。在干预组的药店,药剂师和非依从性风险高的患者在面对面的会议上讨论了在药片上显示的个人障碍,并与他们的全科医生和执业护士分享。药剂师发起了针对性的干预措施。 Barriers of control patients were not presented nor discussed and these patients received usual care. The primary outcome was the effectiveness of the intervention on medication adherence at 8 months’ follow-up between patients with an increased nonadherence risk from the intervention and control groups, calculated from dispensing data. Results: Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (B=–0.01; 95% CI –0.59 to 0.57; P=.96), nor in the post hoc per-protocol analysis (B=0.19; 95% CI –0.50 to 0.89; P=.58). Conclusions: This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effectiveness were identified. These explanations relate, for instance, to high medication adherence in the control group, study power, and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. Trial Registration: The Netherlands National Trial Register NTR5186; https://tinyurl.com/5d8w99hk SN - 1438-8871 UR - //www.mybigtv.com/2022/4/e16141 UR - https://doi.org/10.2196/16141 UR - http://www.ncbi.nlm.nih.gov/pubmed/35389359 DO - 10.2196/16141 ID - info:doi/10.2196/16141 ER -
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