斯诺TY -的盟,Kyma盟——Versluis Anke AU - Bakema,中盟——范Luenen Sanne AU - Kooij设计,马塞尔·J AU - van den Heuvel, J Maurik盟——Teichert玛蒂娜盟——Honkoop Persijn J AU - van Boven F M盟-通知工作,尼尔斯·H盟——Aardoom Jiska J PY - 2022 DA - 2022/6/8 TI -一个Pharmacy-Based电子健康干预促进哮喘和慢性阻塞性肺病患者正确使用药物:非随机前-后研究JO - J医学互联网Res SP - e32396 VL - 24 IS - 6kw -哮喘KW - COPD KW -药物依从性KW -加重KW -药房KW - eHealth AB -背景:哮喘和慢性阻塞性肺疾病(COPD)影响着全球数百万人。虽然药物可以控制和改善疾病症状，但不正确使用药物是一个常见的问题。电子健康干预SARA(服务药剂师呼吸咨询)旨在通过提供信息和药剂师根据需要量身定制的后续支持，改善参与者正确使用吸入药物。目的:本研究的主要目的是探讨SARA对哮喘和COPD患者急性加重率的影响。次要目的是调查其在坚持维持药物和抗真菌治疗方面的影响。方法:在这项非随机的前后研究中，包括来自382个荷兰社区药房的药物配药数据。通过分配短期口服皮质类固醇来评估加重率。通过计算分配吸入维持药物的天数比例，评估了新使用者和长期使用者之间的药物依从性。抗真菌治疗的研究从分配口服抗真菌药的参与者谁也分配吸入皮质类固醇(ICS)。 Outcomes were assessed 1 year before and 1 year after implementation of SARA and were compared between SARA participants and control participants. More specifically, for exacerbation rates and medication adherence, a difference score was calculated (ie, 1 year after SARA minus 1 year before SARA) and was subsequently compared between the study groups with independent-samples t tests. For antimycotics, the relative number of participants who were dispensed antimycotics was calculated and subsequently analyzed with a mixed-effects logistic regression. Results: The study population comprised 9452 participants, of whom 2400 (25.39%) were SARA participants. The mean age of the population was 60.8 (15.0) years, and approximately two-thirds (n=5677, 60.06%) were female. The results showed an increase in mean exacerbation rates over time for both study groups (SARA: 0.05; control: 0.15). However, this increase in exacerbation rates was significantly lower for SARA participants (t9450=3.10, 95% CI 0.04-0.16; P=.002; Cohen d=0.06). Chronic users of inhalation medication in both study groups showed an increase in mean medication adherence over time (SARA: 6.73; control: 4.48); however, this increase was significantly higher for SARA participants (t5886=–2.74, 95% CI –3.86 to –0.84; P=.01; Cohen d=–0.07). Among new users of inhalation medication, results showed no significant difference in medication adherence between SARA and control participants in the year after implementation of SARA (t1434=–1.85, 95% CI –5.60 to 0.16; P=.06; Cohen d=–0.10). Among ICS users, no significant differences between the study groups were found over time in terms of the proportion of participants who were dispensed antimycotics (t5654=0.29, 95% CI –0.40 to 0.54; P=.76; Cohen d=0). Conclusions: This study provides preliminary evidence that the SARA eHealth intervention might have the potential to decrease exacerbation rates and improve medication adherence among patients with asthma and COPD. SN - 1438-8871 UR - //www.mybigtv.com/2022/6/e32396 UR - https://doi.org/10.2196/32396 UR - http://www.ncbi.nlm.nih.gov/pubmed/35675120 DO - 10.2196/32396 ID - info:doi/10.2196/32396 ER -