Cross-platform remote monitoring technologies to monitor and improve adherence to

跨平台远程监控技术，用于监控和提高遵守情况

• 批准号: 8445454
• 负责人: Barbara Ann Rapchak
• 金额: $ 44.92万
• 依托单位: LEAP OF FAITH TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-29 至 2014-09-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8445454
• 关键词: Academia; Activities of Daily Living; Adherence; Admission activity; Adoption; Adverse effects; Affect; Age; Aging; American; Americas; Apple; Back; Businesses; Cancer Center; Cancer Patient; Caring; Cellular Phone; Cessation of life; Chronic Disease; Clinical; Clinical Trials; Collaborations; Communication; Computer software; Data; Data Aggregation; Data Display; Devices; Disease; Disease Progression; Dose; Elderly; Event; Expenditure; Focus Groups; Fortune; Fostering; Frequencies; Health Status; Healthcare; Healthcare Industry; Healthcare Systems; Hospitalization; Hospitals; Industry; Informatics; Internet; Journal of the National Cancer Institute; Letters; Life Style; Marketing; Medicine; Monitor; National Institute on Aging; North Carolina; Nursing Research; Oral; Outcome; Patient Care; Patient Outcomes Assessments; Patients; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacy facility; Phase; Philadelphia; Physicians; Pilot Projects; Provider; Publishing; Quality of life; Radio; Randomized Controlled Trials; Relative (related person); Reporting; Research; Robert H Lurie Comprehensive Cancer Center of Northwestern University; Running; Sampling; Schedule; Science; Self Efficacy; Small Business Innovation Research Grant; Solutions; Staging; Symptoms; System; Technology; Testing; Therapeutic; Therapeutic Index; Time; Touch sensation; Toxic effect; United States; Universities; Visit; Wireless Technology; Work; base; behavioral health; clinically significant; college; commercialization; cost; demographics; design; improved; medical supply; medication compliance; preference; prevent; prototype; research and development; success; usability; web interface; web services

DESCRIPTION (provided by applicant): Medication nonadherence is a costly healthcare problem, adding $177 billion annually to the nation's healthcare expenditures. Three out of four Americans do not take their medicine as prescribed, and the ramifications affect virtually every aspect of the health care system. It is called America's other drug problem for good reason. Nonadherence issues are particularly troublesome with oral chemotherapeutic medications, which are increasingly entering the market, and which often have severe toxicities and narrow therapeutic indices. A review of adherence published in the Journal of the National Cancer Institute found that up to 80 percent of cancer patients failed to follow their prescriptions. There is not a "one size fits all" solution to the adherence problem. Thus, this Fast Track application aims to facilitate widespread adoption of promising telemonitoring technology for improving medication adherence by extending it to additional wireless platforms to make it accessible to broad sociodemographic groups. It fosters partnerships among collaborators from academia, healthcare, and industry working together toward this aim. The proposed RandD would enable us to make very promising technology available to more people who could benefit from it by acknowledging their age, lifestyle, disease state, and preference for a particular communication strategy and platform. The existing technology was developed through a Small Business Innovation Research (SBIR) grant from the National Institute on Aging. It integrates cell phones, radio frequency identification (RFID), and health and behavioral informatics to optimize medication compliance, track medication use, and extend patient care to the ambulatory setting. It has consistently demonstrated adherence rates of 96 percent to 98 percent, along with clinically significant improvements in self efficacy, in randomized control studies among elderly chronic disease and cancer patients taking from 1 to 11 medications/day. Usability testing was conducted by an independent third party at NCI's User-Centered Informatics Research Lab with outstanding success. Patients reported that the technology makes them feel more confident that they will be able to manage their medications. Clinicians participating in the usability testing gave the clinical interface and Web service high marks, calling it "a great boon for the research nurse or clinical trial coordinator." We will extend the existing telemonitoring technology, which runs on a cellphone/PDA, to three new platforms: a low-cost smartphone, the Apple iPhone, and an Internet appliance called Chumby. Work will proceed through six stages. In Phase I we will: (1) develop functional prototypes on three new platforms (2) conduct focus groups to evaluate acceptance by patient end-users, and end-user demographics relative to preference for a particular platform. In Phase II we will: (3) develop full functionality on three new platforms based on focus group input (4) integrate and aggregate adherence and patient reported outcomes data from all platforms through a single web service and user interface (5) conduct a pilot study to demonstrate technical feasibility and assess usability and efficacy (6) assess acceptance of the web service and clinical interface among a sample of clinicians, physicians, providers, and stakeholders in the pharmaceutical supply chain.

描述（由申请人提供）：药物不依从性是一个代价高昂的医疗保健问题，每年为国家的医疗保健支出增加1770亿美元。四分之三的美国人不按处方服药，其后果几乎影响到医疗保健系统的各个方面。它被称为美国的另一个毒品问题是有充分理由的。口服化疗药物的不依从性问题尤其令人烦恼，口服化疗药物越来越多地进入市场，并且通常具有严重的毒性和狭窄的治疗指数。发表在《国家癌症研究所杂志》上的一项关于依从性的评论发现，高达80%的癌症患者没有遵循他们的处方。没有一个“一刀切”的解决方案的坚持问题。因此，该快速通道应用程序旨在通过将其扩展到其他无线平台，使其可用于广泛的社会人口群体，从而促进广泛采用有前途的远程监护技术，以提高药物依从性。它促进学术界、医疗保健和工业界合作者之间的伙伴关系，共同努力实现这一目标。拟议的RandD将使我们能够向更多的人提供非常有前途的技术，这些人可以通过承认他们的年龄，生活方式，疾病状态以及对特定通信策略和平台的偏好而从中受益。现有的技术是通过国家老龄化研究所的小企业创新研究（SBIR）资助开发的。它集成了手机，射频识别（RFID），健康和行为信息学，以优化药物依从性，跟踪药物使用，并将患者护理扩展到门诊环境。在老年慢性病和癌症患者中进行的随机对照研究中，每天服用1至11种药物的依从率一直在96%至98%之间，沿着自我效能的临床显著改善。可用性测试由独立的第三方在NCI的以用户为中心的信息学研究实验室进行，并取得了巨大的成功。患者报告说，这项技术使他们对管理药物更加有信心。参与可用性测试的临床医生对临床接口和Web服务给予了很高的评价，称其为“对研究护士或临床试验协调员来说是一个巨大的布恩。“我们将把现有的远程监护技术（运行在手机/PDA上）扩展到三个新的平台：一个低成本的智能手机、苹果iPhone和一个名为Chumby的互联网设备。工作将分六个阶段进行。在第一阶段，我们将：（1）在三个新平台上开发功能原型（2）进行焦点小组讨论，以评估患者最终用户的接受程度，以及与特定平台偏好相关的最终用户人口统计数据。在第二阶段，我们将：（3）根据焦点小组的意见，在三个新平台上开发全部功能（4）通过单一网络服务和用户界面，整合和汇总来自所有平台的依从性和患者报告的结果数据（5）进行试点研究，以证明技术可行性，并评估可用性和有效性（6）评估临床医生、内科医生、提供者以及医药供应链中的利益相关者。