Text messaging intervention to improve adherence for TB patients in Argentina

短信干预提高阿根廷结核病患者的依从性

• 批准号: 8332908
• 负责人: Sarah Jo Hannah Iribarren
• 金额: $ 3.6万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-15 至 2013-07-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8332908
• 关键词: Address; Adherence; Adopted; Algorithms; Americas; Applications Grants; Area; Argentina; Car Phone; Caring; Client; Clinic; Clinical; Clinical Management; Clinical Treatment; Collaborations; Communicable Diseases; Communication; Communications Media; Communities; Computer software; Computers; Consent; Control Groups; Data; Decision Making; Development; Discipline of Nursing; Disease; Disease Outcome; Education; Evaluation; Feedback; Feeling; Fellowship; Goals; Group Interviews; HIV; Health; Health Personnel; Healthcare; Hospitals; Human; Individual; Intervention; Interview; Knowledge; Mediating; Medical Care Team; Methods; Monitor; National Institute of Nursing Research; Nurses; Outcome; Outpatients; Participant; Patient Care Team; Patients; Pattern; Perception; Pharmaceutical Preparations; Phase; Physicians; Pilot Projects; Process; Protocols documentation; Provider; Province; Public Health; Randomized; Recommendation; Reporting; Research; Research Priority; Scientist; Self Administration; Services; Sputum; Stigmata; Structure; System; Technology; Text; Training; Treatment outcome; Tuberculosis; Visit; World Health Organization; base; combat; cost; design; effective therapy; follow-up; group intervention; improved; informant; innovation; medication compliance; new technology; prevent; programs; skills; social stigma; standard of care; success; tool; treatment adherence; tuberculosis treatment

DESCRIPTION (provided by applicant): The long term goal of this training grant application is to support development of the applicant as a nurse scientist with the knowledge and skills to conduct research focused on improving infectious disease outcomes internationally. The fellowship will concentrate on dissertation research focused on evaluating an innovative intervention developed in collaboration with a TB specialized healthcare team and patients to improve treatment outcomes related to tuberculosis. Tuberculosis (TB) is a challenging global public health problem. The World Health Organization (WHO) recommends direct observation of treatment (DOT), in which a trained health care worker witnesses the daily administration of medication, as the standard for treating TB. Use of DOT is challenging and when DOT is not feasible, patient self-administration (SAT) is often used. In Argentina, treatment success rates remain well below the WHO recommended rates. In 2007 of the reported sputum smear-positive cases 54% were documented to have received DOT countrywide and only 20% in the Province of Buenos Aires, moreover default rate (patient-interrupted treatment for at least two months) was 14.5%. A current objective to improve TB care outcomes is to heighten TB patients' involvement in their own care, and improve communication between patients and care team. A promising tool to build on these goals is the use of text messaging or SMS (Short Message Service) via mobile phones, an increasingly ubiquitous global communications medium. The proposed research is a mixed-method, phased design pilot study guided by a socio-technical approach. The first phase will include finalizing the intervention protocol (e.g. socially and culturally appropriate educational text messages and a clinical workflow algorithm to address and respond to text messaging issues or other potential situations) in collaboration with the TB-specialized healthcare team at the reference hospital in Argentina. Phase 2 is an exploratory pilot study using mixed methods to evaluate the feasibility and initial efficacy of the text messaging based intervention. Study aims are to: (1) develop and examine the efficacy of a text messaging computer-based system intervention on patient outcomes; (2) evaluate the structure and process of delivering the intervention; and (3) explore perceptions of acceptance, feasibility, and how to optimize the intervention from the perspective of TB patients. Forty eligible and consented participants will be randomized to a control group receiving standard of care self administration of treatment (SAT) or to an intervention group receiving SAT plus the text messaging intervention. In-depth individual or group interviews will be conducted at the end of the two month intensive TB treatment phase. Outcomes are medication adherence rates, sputum smear conversion rates, and acceptance and feasibility of intervention at the end of the two month intensive treatment phase. The SMS based intervention for TB management, addresses the National Institute of Nursing Research's priorities to adopt new technologies for better health care outcomes and to promote health and prevent disease.

描述（由申请人提供）：该培训赠款申请的长期目标是支持申请人作为护士科学家的发展，并具有知识和技能，以进行研究，重点是在国际上改善感染性疾病成果。奖学金将集中于论文研究，重点是评估与结核病专业医疗团队和患者合作开发的创新干预措施，以改善与结核病相关的治疗结果。结核病（TB）是一个具有挑战性的全球公共卫生问题。世界卫生组织（WHO）建议直接观察治疗（DOT），其中训练有素的卫生保健工作者见证了每日药物治疗，作为治疗结核病的标准。 DOT的使用是具有挑战性的，当DOT不可行时，经常使用患者自我管理（SAT）。在阿根廷，治疗成功率远低于WHO推荐利率。在2007年，据报道，有54％的痰涂片阳性病例已记录在全国范围内获得DOT，在布宜诺斯艾利斯省只有20％，此外，默认率（至少两个月的患者中断治疗）为14.5％。改善结核病护理结果的目前目标是增强结核病患者自身护理的参与，并改善患者和护理团队之间的沟通。建立这些目标的有前途的工具是通过手机使用文本消息传递或短信（简短消息服务），这是一种越来越无处不在的全球通信媒体。拟议的研究是一项以社会技术方法为指导的混合方法，分阶段的设计试验研究。第一阶段将包括与Argentina参考医院的TB特殊医疗团队合作解决干预方案（例如，在社会和文化上适当的教育文本信息和临床工作流程算法，以解决和应对文本消息问题或其他潜在情况）。第2阶段是一项使用混合方法来评估基于文本消息的干预措施的可行性和初始功效的探索性试验研究。研究的目的是：（1）开发和检查基于文本消息计算机的系统干预对患者预后的疗效； （2）评估提供干预的结构和过程； （3）探索对接受，可行性的看法以及如何从结核病患者的角度优化干预措施。 40名合格和同意的参与者将被随机分为一个对照组接受护理标准的治疗标准（SAT）或接受SAT以及文本消息干预的干预组。深入的个人或小组访谈将在两个月密集的结核病治疗阶段结束时进行。结果是在两个月强化治疗阶段结束时的药物依从率，痰液涂片转化率以及干预的接受度和可行性。基于SMS的结核病管理干预措施介绍了美国国家护理研究所的优先事项，以采用新技术来获得更好的医疗保健结果并促进健康和预防疾病。

项目成果

TextTB: A Mixed Method Pilot Study Evaluating Acceptance, Feasibility, and Exploring Initial Efficacy of a Text Messaging Intervention to Support TB Treatment Adherence.

• DOI: 10.1155/2013/349394
• 发表时间: 2013
• 期刊: Tuberculosis research and treatment
• 作者: Iribarren S;Beck S;Pearce PF;Chirico C;Etchevarria M;Cardinale D;Rubinstein F
• 通讯作者: Rubinstein F

Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials.

• DOI: 10.1177/1744987112466087
• 发表时间: 2013-03
• 期刊: Journal of research in nursing : JRN
• 作者: Galante J;Iribarren SJ;Pearce PF
• 通讯作者: Pearce PF