高血圧の成人の治療遵守を支援する携帯電話のテキストメッセージ (SMS-Text Adherence Support [StAR]):単盲,ランダム化試験

Kirsten Bobrow¹, Andrew J Farmer², David Springer¹

¹From Institute of Biomedical Engineering, Department of Engineering Science (K.B., D.S., T.B., L.T.) and Nuffield Department of Primary Care Health Sciences (K.B., A.J.F., M.S., L.-M.Y.), University of Oxford, UK; Chronic Disease Initiative for Africa, Cape Town, South Africa (K.B., K.S., N.L.); Division of Nephrology and Hypertension, Groote Schuur Hospital, Cape Town, South Africa (B.R.); University of Cape Town, South Africa (B.R.); Western Cape Province Department of Health, Cape Town, South Africa (M.N.); and Division of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, South Africa (N.L., K.B.).

Circulation

|January 16, 2016

まとめ

携帯電話のテキストメッセージ (SMS) は,高血圧患者の静脈動脈圧のわずかな低下を示した. インタラクティブSMSは,通常の治療と比較して,この効果を大幅に増加させなかった.

科学分野:

公衆衛生
デジタルヘルスの介入
心血管疾患の管理

背景:

高血圧の管理には,一貫した治療が必要である.
携帯電話による介入は順守を支えるための拡張可能なアプローチです
自動ショートメッセージシステム (SMS) のテキストメッセージは,アデバーンスサポートを提供することができます.

研究の目的:

血圧管理に対する自動化されたSMSメッセージの影響を評価する.
高血圧管理のための情報のみのSMS,インタラクティブSMS,通常のケアを比較する.
デジタル化支援の効果を現実の環境で評価する.

主な方法:

南アフリカで実施された実用的な,単盲の3組のランダム化試験 (StAR研究).
1372人の高血圧患者は,情報のみのSMS,インタラクティブSMS,または通常のケアに割り当てられました.
主要アウトカム: 12ヶ月のシストリック血圧の変化,オシロメトリック装置で測定.

主要な成果:

通常の治療と比較して,平均調整した静脈動脈血圧の低下がみられた.
インタラクティブSMSでは,通常の治療と比較して平均1. 6mmHgの調整された減少を示した.
両方のSMS群では,通常の治療と比較して,血圧が<140/ 90mmHgに達する確率は高かった.

結論:

自動化されたSMSアデンスサポートにより,収縮血圧は小さく,しかし有意に低下した.
インタラクティブなSMSは,情報のみのSMSよりも血圧制御に大きな効果を示さなかった.
SMSベースの介入は,一般診療中の高血圧管理を支援する有効なツールです.

キーワード:

行動療法医療の提供患者の順守ランダム化制御試験自己介護

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