一个多层次的mHealth干预措施提高了状细胞疾病患者对基尿素的坚持
Jane S Hankins1,2,3, Donald Brambilla4, Michael B Potter5
1Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN.
Blood advances
|September 22, 2023
概括
移动卫生干预措施改善了酸的坚持性,并减少了状细胞疾病的并发症. 值得注意的是,InCharge健康应用程序对患者有显著的好处,而HU工具箱的供应商采用程度有限.
科学领域:
- 血液学 血液学 血液学
- 数字健康数字健康
- 公共卫生 公共卫生
背景情况:
- 氧尿素对于治疗状细胞疾病 (SCD) 并发症至关重要.
- 低剂量药物坚持和处方率限制了氧尿素的有效性.
- 移动健康 (mHealth) 干预提供了改善遵守和处方的潜在解决方案.
研究的目的:
- 评估两个mHealth干预措施对SCD患者的基尿素坚持和临床结果的影响.
- 评估患者与InCharge Health应用程序的互动,以及医疗服务提供者如何使用HU工具箱.
- 将干预期间和干预后的结果与干预前的基线进行比较.
主要方法:
- 一个多中心的非随机试验,涉及293名SCD患者 (15-45岁) 和89名医疗保健提供者.
- 干预措施包括为患者提供InCharge健康和为提供者提供HU工具箱.
- 在干预24周和研究后12周测量结果,包括覆盖日数百分比 (PDC),HbF水平,医疗保健利用率和自我报告的疼痛.
主要成果:
- 在干预期间 (P < 0.001) 平均PDC从39.7%显著增加到56.0%,并在干预后持续.
- 平均HbF水平增加 (P = 0.03),自我报告的疼痛频率减少 (P = 0.041).
- 患者使用InCharge Health (84.7%实施) 与PDC增加相关,特别是在私人保险和老年患者中.
- 供应商采用HU Toolbox的比例很低 (11.2%),对PDC没有显著的影响.
结论:
- 量身定制的mHealth解决方案可以有效地改善基尿素的坚持性,并在SCD患者中产生临床益处.
- 负责健康应用程序展示了患者参与和积极的结果,突出其潜力.
- 需要进一步的研究,包括一项最终的随机对照试验,以证实这些发现.
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