RE-aiming at Hydroxyurea Adherence for Sickle cell with mHealth (RE-HASH)

通过 mHealth 重新瞄准镰状细胞的羟基脲依从性 (RE-HASH)

• 批准号: 9180381
• 负责人: Jane Silva Hankins
• 金额: $ 78.67万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-08 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9180381
• 关键词: Address; Adherence; Adolescent; Adopted; Adoption; Adult; Age; American; Area; Attention; Behavior; Benefits and Risks; Caring; Cellular Phone; Child; Chronic Disease; Clinic; Clinical; Cohort Studies; Collaborations; Communities; Continuity of Patient Care; Country; Data; Effectiveness; Ensure; Event; Family; Fetal Hemoglobin; Fostering; Funding; Future; Genotype; Goals; Health; Health Care Costs; Health Technology; Health system; Home environment; Hospitalization; Individual; Intervention; Interview; Laboratories; Lead; Life; Link; Maintenance; Measures; Medical; Medical Care Costs; Medicare/Medicaid; Medicine; Modeling; Oral; Outcome; Participant; Patient Preferences; Patients; Penetration; Perception; Pharmaceutical Preparations; Pharmacy facility; Phase; Phenotype; Population; Populations at Risk; Provider; Qualitative Evaluations; Quality of life; Randomized; Regimen; Sampling; Self Efficacy; Sickle Cell; Sickle Cell Anemia; System; Testing; Text; Transfusion; Work; arm; base; clinical effect; cohort; community center; cost; demographics; design; evidence base; formative assessment; handheld mobile device; health care service utilization; health literacy; health related quality of life; hydroxyurea; implementation science; improved; innovation; instrument; mHealth; mean corpuscular volume observed; medication compliance; mobile computing; patient oriented; patient registry; patient stratification; preference; standard of care

PROJECT SUMMARY Hydroxyurea is a once-a-day oral medication that reduces hospitalizations, transfusions, and medical care costs among patients with sickle cell disease (SCD). Despite these positive benefits, hydroxyurea is not widely used, which reduces the clinical benefits of the drug. The main factors include misperceptions by patients and providers regarding the risks and benefits of hydroxyurea and patients’difficulty in remembering to take the medication. Our long-term goal is to foster increased use of hydroxyurea among patients with SCD through the use of mobile technology. Our initial approach in Aim 1 is to fully understand all factors influencing the initiation or continuation of hydroxyurea therapy by patients, families, and providers. For this, we will interview patients, families, providers, and analyze Medicaid, Medicare, and commercial payer data. We will link the data from the medical system (payer data), with that of individuals, families, and providers. We will identify the reasons hydroxyurea is started and continued. Next, in Aim 2, we will develop and test a new cellular phone text messaging application that will help patients stay on hydroxyurea. We will seek input from patients inquiring about their preferences and perceptions of useful features of a new text messaging application. We will then test this new text messaging application in a group of adolescents and adults in Memphis. We will pay particular attention to how providers and patients see the importance of this intervention and how well it works to improve the effect of HU treatment, such as, improvement of laboratory measures, quality of life. We will then further improve the application based on these initial results. Lastly, in Aim 3, we will expand the testing of this new text messaging application in a large randomized study of patients in different geographical areas of the country. We will study how well it is adopted by patients and providers, how much it changed the patients’ perception regarding the difficulties in taking their medication, its costs, and how well it worked to increase HU clinical benefits. Throughout our study, we will use the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation science model to help us measure the large-scale impact of text messaging in the treatment of patients with SCD with hydroxyurea. Ultimately, it is the goal of this project to provide evidence for an effective, low cost, and accessible mobile health technology (cellular phone text messaging) that will lead to better usage of hydroxyurea and improvement of overall health outcomes of individuals living with SCD.

项目总结 羟基脲是一种每天一次的口服药物，可以减少住院、输液和医疗护理。 镰状细胞病(SCD)患者的费用。尽管有这些积极的好处，羟基脲并没有广泛应用 使用，这降低了药物的临床益处。主要因素包括患者的误解和 关于羟基尿素的风险和益处以及患者记忆困难的提供者 药物治疗。我们的长期目标是促进SCD患者更多地使用羟基脲 移动技术的使用。在目标1中，我们的初步方法是充分了解影响启动的所有因素 或患者、家属和提供者继续接受羟基脲治疗。为此，我们将采访患者， 家庭、提供者和分析Medicaid、Medicare和商业付款人数据。我们将链接来自 医疗系统(付款人数据)，以及个人、家庭和提供者的数据。我们会找出原因 羟基脲被启动并继续。接下来，在目标2中，我们将开发和测试一种新的手机短信 消息传递应用程序，将帮助患者继续服用羟基脲。我们会征询病人的意见 关于他们对新文本消息应用程序有用功能的偏好和看法。到时候我们会的 在孟菲斯的一群青少年和成年人中测试这个新的短信应用程序。我们会付钱的 特别注意提供者和患者如何看待这种干预的重要性以及其效果如何 以改善HU治疗效果，如改善实验室措施、生活质量等。我们会 然后在这些初步结果的基础上进一步改进应用。最后，在目标3中，我们将扩大对 这一新的短信应用程序在一项大型随机研究中对不同地理区域的患者进行了研究 这个国家。我们将研究它被患者和提供者采用的情况，它在多大程度上改变了患者的 对他们服药的困难、费用以及增加HU的效果的看法 临床益处。在整个研究过程中，我们将使用RE-AIM(REACH、有效性、采用、 实施和维护)实施科学模型，帮助我们衡量 短信在羟基脲治疗SCD患者中的应用归根结底，这是这个项目的目标 为有效、低成本和可获得的移动医疗技术(手机短信)提供证据 消息)，这将导致更好地使用羟基尿素，并改善 患有SCD的个人。