基于nudge的干预措施,以改善慢性疾病成年人的药物坚持:随机对照试验的系统审查和元分析
Zhongtian Zhou1, Yun Zhang1, Junfang Xu1
1School of Public Health, Zhejiang University and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China.
概括
基于nudge的干预措施显示了改善慢性疾病成年人的药物服药能力的潜力. 需要进一步的研究来加强这些有前途的战略的证据基础.
科学领域:
- 行为科学 行为科学
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
背景情况:
- 药物坚持对于治疗慢性疾病至关重要,但往往不够理想.
- 基于刺激的干预措施对健康行为有希望,但它们对药物坚持的影响尚不清楚.
研究的目的:
- 评估基于推动的干预措施在改善患有慢性疾病的成年人服用药物的有效性.
主要方法:
- 在2014年1月1日至2024年11月23日期间发表的随机对照试验 (RCT) 的6个数据库中进行系统搜索.
- 用随机效应模型计算标准化平均差异的19个RCT (N=2690) 的元分析 (Hedges' g).
- 偏差风险的评估,异质性 (科克兰Q,I2) 和出版偏差 (埃格尔测试).
主要成果:
- 基于nudge的干预措施对药物坚持有显著的积极影响 (Hedges的g=0.68,P<.01).
- 观察到显著的异质性 (I2 = 96.3%),促使分组分析.
- 没有检测到出版偏差.
结论:
- 基于nudge的干预措施有可能提高慢性疾病成年人的药物坚持.
- 建议进一步进行高质量的研究,以巩固这些发现并指导临床实践.
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