A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine
A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine
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DOI：
10.1177/0333102418756864
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发表时间：
2018-12-01
期刊：
影响因子：
4.9
通讯作者：
Hommel, Kevin A.
中科院分区：
文献类型：
--
作者：
Ramsey, Rachelle R.;Holbein, Christina E.;Hommel, Kevin A.
背景：偏头痛的有效治疗需要遵守治疗建议；然而，青少年偏头痛患者每天只有75%的时间服用药物。使用技术的低成本、以依从性为重点的干预措施可能会提高依从性，但尚未进行调查。方法35例青少年和青壮年(13-21岁)偏头痛患者参加了AB设计的试点研究，以评估手机依从性促进应用程序(APP)和渐进式提醒系统的使用情况。使用基线期间的电子监测和药物依从性干预来计算依从性。结果与基线相比，在干预的第一个月，患者的依从性显著提高。具体地说，对于基线依从性较低的老年参与者来说，情况有所改善。自我报告的基于APP的遵从率显著低于电子监控的遵从率。参与者对干预措施的评价是可以接受的，而且易于使用。结论“APP”具有改善服药依从性的潜力，对于依从性低的青少年和青壮年是一种有前途的干预措施。让父母参与干预也是有帮助的。提供者应评估遵守和使用基于技术的干预措施的障碍，鼓励父母纳入行为激励措施，并为更密集的干预措施提供转介，以改善长期结果。此外，在应用程序中跟踪遵从性可能会导致对遵从性的低估。未来应该进行全面的研究，以检查依从性促进APP的干预。
Background Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated. Methods Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. Results Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use. Conclusions "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.