eMedonline: Telehealth Medication Management System

描述（由申请人提供）：药物治疗是一种相对便宜和有效的治疗策略，用于治疗许多疾病。然而，慢性治疗患者的平均依从率在一年后约为50%，并随着时间的推移而下降。大约10%的住院患者与药物问题有关，23%的疗养院患者与药物问题有关。据估计，不遵医嘱每年给美国医疗保健系统造成766亿美元的损失。在接受药物治疗的人群中，老年人是一个重要的群体。她们收到了所有处方的30%，购买了所有非处方药的40%。2003年，美国65岁及以上的老年人估计有3600万人，几乎占总人口的13%。无法管理药物是老年人需要额外的、往往更昂贵的护理的主要原因之一。了解不遵守的原因并确定帮助患者遵循其方案的方法可以改善健康结果并降低相关费用。这样的方法将促进就地老化，并可能推迟进入辅助生活设施的需要。健康决策模型表明，不服从行为是多因素的。通过改变一般和特定的健康信念，加强社会互动因素，优化管理，可以提高依从性。在II期研究中，我们拟确定eMedonline用药管理系统是否能提高老年高血压患者的依从性。我们将在患者样本中评估药物依从性、感知到的社会支持和对健康命运的控制感的影响。我们还将在医疗保健提供者、药剂师和护理人员的样本中评估该系统的可接受性。

DESCRIPTION (provided by applicant): Medication is a relatively inexpensive and efficient therapeutic strategy for treating a number of illnesses. However, the average rate of compliance for patients on chronic therapies is about 50% after one year and declines over time. Approximately 10% of hospital admissions are related to medication issues, and 23% of nursing home admissions are related to medication problems. Medication noncompliance is estimated to cost the US healthcare system an estimated $76.6 billion a year. The elderly represent an important population among those receiving drug therapy. They receive 30% of all prescriptions and buy 40% of all over-the-counter drugs. In 2003, there were an estimated 36 million people age 65 or older in the United States, accounting for almost 13% of the total population. The inability to manage medications is one of the leading reasons why seniors need additional, often more expensive care. Understanding the causes of noncompliance and identifying methods to help patients follow their regimens may improve health outcomes and reduce related costs. Such a methodology would facilitate aging in place and may delay the need for admission to assisted living facilities. The health decision model suggests that noncompliant behavior is multi-factorial. By modifying general and specific health beliefs, enhancing social interaction factors, and optimizing administration, compliance can be improved. In Phase II, we propose to determine whether the eMedonline medication management system improves compliance among elderly patients being treated for hypertension. We will evaluate effects on medication compliance, perceived social support, and feelings of control over health destiny in a sample of patients. We will also evaluate the acceptability of the system in a sample of healthcare providers, pharmacists, and caregivers.