mHealth intervention to improve medication management in chronically ill patients: analysis of the recruitment process
mHealth intervention to improve medication management in chronically ill patients: analysis of the recruitment process
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DOI：
10.1080/00325481.2016.1170580
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发表时间：
2016-05-01
影响因子：
4.2
通讯作者：
Codina-Jane, Carles
中科院分区：
文献类型：
--
作者：
Anglada-Martinez, Helena;Rovira-Illamola, Marina;Codina-Jane, Carles
目的：移动的电话已迅速为大众所采用，现在是一种有前途的技术，在保健方面具有相当大的潜力。然而，在远程医疗研究中报告的拒绝率为24%-75%。我们的目的是报告所面临的挑战时，招募患者使用Android和iOS的智能手机应用程序，旨在改善药物管理和患者之间的沟通和health professionals.Methods：受邀参加的患者有心力衰竭和/或高血压和/或血脂异常。在达到入选所需的参与者数量后，对招募过程进行了分析，研究小组确定了拒绝的原因。结果：在被邀请参加的448名潜在参与者中，有210人做出了回应。其中，37.1%的人不使用智能手机，2.9%的人拥有既不是iOS也不是Android的移动的手机，28.6%的人是拒绝参与的智能手机用户。在这种情况下，最常见的动机是患者认为他们的常规医疗保健足够，并且没有麻烦记得吃药（81.7%）。最终研究样本包括48名患者。入选患者的平均年龄显著低于未入选的参与者（分别为59.9 ± 10.6岁和66.8 ± 11.4岁; p=0.00）。结论：我们发现年龄是医疗保健中使用智能手机的重要障碍。在智能手机用户中，良好的依从性和足够的常规医疗保健是拒绝参与的最常见原因。因此，这种类型的干预可以提高参与的穷人遵守或照顾者。实施教育计划可以在改善患者对技术的看法方面发挥关键作用。
Objectives: Mobile phones have been rapidly adopted by the general population and are now a promising technology with considerable potential in health care. However, refusal rates of 24%-75% have been reported in telemedicine studies. We aimed to report the challenges faced when recruiting patients to use Android and iOS smartphone applications aimed at improving medication management and communication between patients and healthcare professionals.Methods: The patients invited to participate had heart failure and/or hypertension and/or dyslipidemia. After reaching the number of participants required for inclusion, the recruitment process was analyzed, and the study team determined the reasons for refusal.Results: Of the 448 potential participants who were invited to participate, 210 responded. Of these, 37.1% did not use a smartphone, 2.9% owned a mobile phone that was neither iOS nor Android, and 28.6% were smartphone users who refused to participate. In this case, the most common motive was that patients considered their routine healthcare sufficient and had no trouble remembering to take their medicines (81.7%). The final study sample comprised 48 patients. The mean age of the patients enrolled was significantly lower than that of participants who were not included (59.9 10.6 vs. 66.8 +/- 11.4 years, respectively; p=0.00).Conclusion: We found age to be an important barrier to smartphone use in healthcare. Among smartphone users, good adherence and sufficient routine healthcare were the most common reasons for refusal to participate. Thus, this type of intervention could enhance participation for poor adherers or caregivers. Implementing educational initiatives could play a key role in improving patient perceptions of technology.