A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation
A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation
复制标题
移动应用程序提高了接受康复治疗的老年患者的治疗依从率
作者：
Alexander Mertens;Christopher Brandl;T. Miron;C. Schlick;T. Neumann;A. Kribben;S. Meister;C. Diamantidis;U. Albrecht;P. Horn;S. Becker
药物依从性是慢性病患者成功治疗的关键。本研究分析了旨在支持药物摄入和生命体征参数记录的平板电脑上的移动的应用程序是否会影响老年患者的依从性。他们收到了安装在苹果iPad上的移动的应用程序“药物计划”的个人介绍。本研究采用3个序列的交叉设计进行：初始阶段、干预阶段（使用app系统28天）和比较阶段（使用纸质日记28天）。使用者交替经历干预和比较阶段。共有24例患者（12例男性;平均年龄73.8岁）入组研究。研究前主观评估的依从性平均值（A14量表; 5分制李克特量表，从“从不”到“非常频繁”，评分范围为0 - 56）为50. 0（SD = 3. 44）。两种干预后均出现显著增加，干预期后（54.0; SD = 2.01）比比较期后（52.6; SD = 2.49）更明显（对于两种干预后的所有配对，P <0.001）。 无论是医疗条件还是每天的药物摄入量（服药量和频率）都不会影响主观依从性。记录数据显示，对于血压记录（P <0.001）和药物摄入（P = 0.033），药物应用程序的依从性明显强于纸质系统。 大多数参与者（n = 22）表示，他们希望在日常生活中使用药物应用程序，并且不需要应用程序的进一步帮助。用于药物依从性的移动的应用程序增加了接受康复的老年用户的客观和主观测量依从性。这些发现具有很好的临床意义：数字化工具可以帮助慢性病患者坚持服药和测量血压。虽然这需要初始离线培训，但它可以减少并发症和由于不依从而导致的临床负荷。
AbstractMedication adherence is crucial for success in the management of patients with chronic conditions. This study analyzes whether a mobile application on a tablet aimed at supporting drug intake and vital sign parameter documentation affects adherence in elderly patients.Patients with coronary heart disease and no prior knowledge of tablet computers were recruited. They received a personal introduction to the mobile application Medication Plan, installed on an Apple iPad. The study was conducted using a crossover design with 3 sequences: initial phase, interventional phase (28 days of using the app system), and comparative phase (28 days of using a paper diary). Users experienced the interventional and comparative phases alternately.A total of 24 patients (12 males; mean age 73.8 years) were enrolled in the study. The mean for subjectively assessed adherence (A14-scale; 5-point Likert scale, from “never” to “very often” which results in a score from 0 to 56) before the study was 50.0 (SD = 3.44). After both interventions there was a significant increase, which was more pronounced after the interventional phase (54.0; SD = 2.01) than after the comparative phase (52.6; SD = 2.49) (for all pairs after both interventions, P <0.001). Neither medical conditions nor the number of drug intake (amount and frequency of drug taking) per day affected subjective adherence. Logging data showed a significantly stronger adherence for the medication app than the paper system for both blood pressure recordings (P <0.001) and medication intake (P = 0.033). The majority of participants (n = 22) stated that they would like to use the medication app in their daily lives and would not need further assistance with the app.A mobile app for medication adherence increased objectively and subjectively measured adherence in elderly users undergoing rehabilitation. The findings have promising clinical implications: digital tools can assist chronic disease patients achieve adherence to medication and to blood pressure measurement. Although this requires initial offline training, it can reduce complications and clinical overload because of nonadherence.