智能手机应用程序,以提高在患有心房的患者的爱多克萨班治疗坚持的自我意识 (ADHERE应用程序试验):随机对照试验
Minjae Yoon1, Ji Hyun Lee1, In-Cheol Kim2
1Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Journal of medical Internet research
|November 21, 2024
概括
智能手机应用程序的干预并没有显著改变EDOXABAN治疗心房动 (AF) 患者的整体药物坚持. 然而,该应用程序改善了足够的药物坚持 (≥95%),特别是在老年人中.
科学领域:
- 心脏病学 心脏病学
- 数字健康数字健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 口服抗凝剂治疗的坚持对于预防心房动 (AF) 患者的缺血性中风至关重要.
- 低于最佳的抗凝固剂坚持,特别是在老年人中,是一个重大的临床挑战.
研究的目的:
- 评估基于智能手机应用程序的干预措施在改善AF患者药物服药的有效性.
- 评估应用程序驱动的反对坚持率和适当的药物坚持的影响.
主要方法:
- 一个开放的,多中心的随机对照试验 (ADHERE-App研究) 涉及AF患者接受edoxaban治疗.
- 患者被随机分配到干预组 (基于应用程序的每日警报和监测) 和对照组 (标准护理).
- 埃多克萨班的坚持主要通过3个月和6个月的药片数量进行评估,重点是≥95%的坚持.
主要成果:
- 在3个月或6个月后,在应用程序干预和对照组之间没有观察到总体埃多克萨班坚持的显著差异.
- 在干预组中,在两个时间点中,达到足够药物坚持的患者比例 (≥95%) 在干预组中显著更高.
- 干预组中老年患者 (>65岁) 显示了更高的药物坚持性和在6个月内充足的药物坚持率.
结论:
- 虽然埃多克萨班的整体坚持没有差异,但智能手机应用程序的干预显著增加了患者实现充分坚持的比例.
- 应用程序干预对药物坚持的好处在老年AF患者中更为明显.
- 智能手机应用程序显示出在口服抗凝剂治疗中改善药物坚持的潜力,特别是在脆弱的老年人群中.
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