个性化患者数据和行为推动改善慢性心血管药物的坚持:随机实证试验
P Michael Ho1,2,3,4, Thomas J Glorioso5, Larry A Allen2
1Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, Colorado.
JAMA
|December 2, 2024
概括
对心血管药物补充的短信提醒没有改善坚持或减少临床事件. 未来的干预措施必须解决影响患者遵守规定的多种因素.
科学领域:
- 医疗服务研究
- 数字健康
- 心血管医学
背景情况:
- 在治疗慢性疾病,尤其是心血管疾病方面, 药物不适应是很大的挑战.
- 短信干预越来越多地被用于改变行为, 但需要严格的有效性测试.
研究的目的:
- 将不同短信策略与改善心血管疾病患者补充药物的常规护理的有效性进行比较.
主要方法:
- 一个患者级的随机实用试验,涉及3个美国医疗保健系统的9501名参与者.
- 干预包括通用提醒,行为推动和聊天机器人的行为推动, 与通常的护理相比.
- 主要结论是12个月后药物补充的坚持 (覆盖日数的比例).
主要成果:
- 在任何短信组和12个月的常规护理之间没有观察到药物坚持的统计学意义上的差异.
- 覆盖日的平均比例从60.6% (常规护理) 到63.0% (行为推动+聊天机器人).
- 在不同组的急诊室访问,住院或死亡率方面没有发现显著差异.
结论:
- 在患有心血管疾病的患者中,短信提醒并没有改善药物坚持或减少临床事件.
- 调查结果表明,仅仅发短信可能不足以克服遵守的障碍.
- 未来的干预措施应考虑多因素的方法来解决药物不合规的复杂原因.
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