A Family-Focused, Literacy-Sensitive Intervention to Improve Medication Adherence

以家庭为中心、对读写能力敏感的干预措施，以提高药物依从性

• 批准号: 8743827
• 负责人: Jia-Rong Wu
• 金额: $ 12.68万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-27 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8743827
• 关键词: Adherence; Admission activity; Americas; Area; Attitude; Behavior; Behavior Control; Cessation of life; Chronic; Communities; Complex; Consensus; Diabetes Mellitus; Educational Intervention; Educational Materials; Educational workshop; Effectiveness; Event; Family; Family Study; Family member; Goals; Health; Health Care Costs; Heart failure; Hospitalization; Hospitals; Hypertension; Individual; Intervention; Intervention Studies; Knowledge; Learning; Measures; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Monitor; Morbidity - disease rate; Natural History; Nurses; Outcome; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Planning Theory; Practical Nursing; Publishing; Quality of life; Randomized; Recruitment Activity; Regimen; Research; Research Personnel; Research Project Grants; Resources; Risk; Self Care; Social support; Societies; Symptoms; System; Testing; Training Programs; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Visiting Nurse; Work; Writing; base; cardiovascular nursing; career; cost; design; effective intervention; follow-up; group intervention; health literacy; high risk; improved; innovation; intervention effect; literacy; medication compliance; meetings; mortality; novel strategies; programs; public health relevance; theories; therapy design; treatment as usual

DESCRIPTION (provided by applicant): This Mentored Patient-Oriented Research Career Development Award will enhance my ability to achieve my long-term career goal of becoming an independent cardiovascular nurse researcher in the area of heart failure (HF). It will allow me to develop and test interventions to improve medication adherence and health outcomes in patients with HF, especially patients with low health literacy. Heart failure is a serious public problem. Up to 50% of patients are readmitted within six months of discharge for HF exacerbations. The natural history of HF can be modified by appropriate therapy but medication adherence is essential to realize this benefit. About 50% of HF patients now have sub-optimal medication adherence with serious consequences including frequent hospitalizations, enormous expense to individuals and society, and poor quality of life. Several interventions have led to improved medication adherence in patients with HF, but, their effects decreased after completion of the intervention. Thus, there is a need for a new approach. My mentoring team (Drs. Michael Pignone, Sandra Dunbar, Darren DeWalt, Carol Golin, and George Knafl) and I have formulated a comprehensive training program of workshops, short courses, and seminars, and a research project that will prepare me for a research career focusing on improving medication adherence in HF. In the proposed project of the K23 award, I will pilot test an integrated family-focused and literacy-sensitive intervention that has the potential to effectively improve medication adherence in patients with HF and enable patients to sustain the improvement. A total of 36 HF patients with sub-optimal medication adherence and their family members will be randomized to intervention or usual care groups. If the study demonstrates the feasibility and efficacy of a clinically practical, nurse-delivered, family-focused and literacy-sensitive intervention to improve medication adherence in patients with HF, the next step will be to develop a larger, more definitive test of the intervention. Interventions to improve medication adherence may decrease the risk of hospitalization and death among patients with HF who have sub-optimal medication adherence.

描述（由申请人提供）：这个指导以病人为导向的研究职业发展奖将提高我的能力，实现我的长期职业目标，成为一个独立的心血管护理研究人员在心力衰竭（HF）领域。它将使我能够开发和测试干预措施，以改善HF患者的药物依从性和健康结果，特别是健康素养低的患者。心力衰竭是一个严重的公共问题。高达50%的患者在出院后6个月内因HF加重而再次入院。HF的自然史可以通过适当的治疗来改变，但药物依从性对于实现这一益处至关重要。目前，约50%的HF患者的药物依从性不佳，严重后果包括频繁住院、个人和社会的巨大费用以及生活质量差。一些干预措施改善了HF患者的药物依从性，但在完成干预后，其效果下降。因此，需要一种新的方法。我和我的导师团队（Michael Pignone、Sandra Dunbar、Darren DeWalt、Carol Golin和乔治Knafl博士）制定了一个全面的培训计划，包括讲习班、短期课程和研讨会，以及一个研究项目，将为我的研究生涯做好准备，重点是提高HF的药物依从性。在K23奖的拟议项目中，我将试点测试一种以家庭为重点、对扫盲敏感的综合干预措施，这种干预措施有可能有效地 改善HF患者的药物依从性，并使患者能够持续改善。共有36名药物依从性不佳的心力衰竭患者及其家人将被随机分配到干预组或常规护理组。如果这项研究证明了临床实用的、护士提供的、以家庭为中心的和识字敏感的干预措施的可行性和有效性，以改善HF患者的药物依从性，下一步将是开发一个更大的、更明确的干预试验。改善药物依从性的干预措施可能会降低药物依从性欠佳的HF患者的住院和死亡风险。