Randomized controlled trial of an education-based intervention to improve medication adherence: Design considerations in the medication adherence in glaucoma to improve care study.
Randomized controlled trial of an education-based intervention to improve medication adherence: Design considerations in the medication adherence in glaucoma to improve care study.
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以教育为基础的干预措施提高药物依从性的随机对照试验：设计青光眼药物依从性的考虑因素以改善护理研究。
DOI：
10.1177/1740774520988291
复制
发表时间：
2021-06
期刊：
影响因子：
2.7
通讯作者：
Muir, Kelly W.
中科院分区：
文献类型：
--
作者：
Rosdahl, Jullia A.;Hein, Aaron M.;Bosworth, Hayden B.;Woolson, Sandra;Olsen, Maren;Kirshner, Miriam;Hung, Anna;Muir, Kelly W.
青光眼治疗需要患者每天遵循，通常是复杂的滴眼方案，但许多患者的依从性很差，使他们面临不可逆视力丧失的风险。需要一种全面的方法来应对青光眼自我管理的挑战。本研究的目的是提高青光眼药物治疗的退伍军人使用教育为基础的干预措施的依从性。这项研究是一项单中心随机对照试验，招募了200名退伍军人及其同伴，如果同伴参与他们的护理。它有两个分支：干预组和控制组。干预组的参与者接受由非医生干预人员进行的教育课程，并获得激活了提醒功能的AdhereTech智能瓶。对照组被设计为注意力控制组，以便他们进行有关一般眼睛健康的课程，并提供智能瓶，但没有激活提醒功能。主要结局是根据智能瓶，随机化后6个月内按计划服用处方剂量的比例。次要结果包括青光眼治疗的强化、干预交付的成本以及12个月内干预的成本效益。我们正在测试的以教育为基础的干预措施范围广泛，包括青光眼患者遇到的各种依从性障碍，但个性化以解决个体患者面临的问题。特别关注现实环境中的可行性，因为患者的高吞吐量和眼科教育遭遇的报销不足将限制资源密集型干预措施的实施。
Glaucoma treatment requires patients to follow daily, often times complex, eye drop regimens, but adherence is poor for many patients, putting them at risk for irreversible vision loss. A comprehensive approach is needed to address the challenges in the self-management of glaucoma. The purpose of this study is to improve glaucoma medication adherence in Veterans with medically treated glaucoma using an education-based intervention. This study is a single-site randomized controlled trial enrolling 200 Veterans and their companions, if companions are involved in their care. It has two arms: an intervention group and a control group. Participants in the intervention group receive an educational session with a non-physician interventionist and are provided with an AdhereTech smart bottle with the reminder functions activated. The control group is designed as an attention control such that they have a session on general eye health and are provided with a smart bottle but without the reminder functions activated. The primary outcome is the proportion of prescribed doses taken on schedule over 6 months following randomization according to the smart bottle. Secondary outcomes include intensification of glaucoma treatment, cost of intervention delivery, and cost-effectiveness of the intervention over 12 months. The education-based intervention that we are testing is comprehensive in scope, to encompass a variety of barriers to adherence that glaucoma patients encounter, but personalized to address issues facing individual patients. Particular attention was given to feasibility in the real-world setting, as the high throughput of patients and lack of reimbursement for educational encounters in ophthalmology would limit implementation of a resource-intensive intervention.
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DOI：
10.1001/jama.2014.3192
发表时间：
2014-05-14
期刊：
JAMA
影响因子：
--
作者：
Weinreb RN;Aung T;Medeiros FA
通讯作者：
Medeiros FA
DOI：
10.1111/j.1532-5415.2011.03770.x
发表时间：
2012-01-01
影响因子：
6.3
作者：
Wolff, Jennifer L.;Boyd, Cynthia M.;Roter, Debra L.
通讯作者：
Roter, Debra L.
影响因子：
2.3
作者：
Kumar, Jaya B.;Bosworth, Hayden B.;Muir, Kelly W.
通讯作者：
Muir, Kelly W.
影响因子：
13.7
作者：
Friedman, David S.;Okeke, Constance O.;Quigley, Harry A.
通讯作者：
Quigley, Harry A.
影响因子：
--
作者：
Stone, Jennifer L.;Robin, Alan L.;Cagle, Gerald D.
通讯作者：
Cagle, Gerald D.