Improving Medication Adherence for Patients with Low Functional Health Literacy:

简介：在整个医疗保健连续体中，由于难以遵循处方药物治疗方案，低功能健康素养的患者可能会有更差的结果。虽然不遵守的原因可以从个人内部、人际关系和系统角度得出；一个出发点是患者很难阅读和理解处方瓶标签上的药物说明。标签可以为患者和医疗保健代理提供重要的提醒和决策支持。然而，必须具备阅读和理解标签的技能。我们将使用“会说话的药瓶”来记录处方药物说明，以便患者可以根据需要在家中重新播放。目的：本研究项目的目的是比较在零售药房购买原发性高血压药物的低功能健康素养患者使用“说话药瓶”与常规护理的比较：a.程序的可行性，b.设备的效用，c.药物依从性，d.药物自我管理的自我效能，e.血压控制。设计：这种新颖的干预措施将在太平洋西北地区的零售药房进行测试。试点试验将采用两个研究组的随机试验设计。分析：组内变化得分的自我效能测量和血压将检查配对t检验；两个治疗组之间的组间测量也将被检查。我们还将跟踪药物复杂性作为潜在的混杂因素，并进行半结构化的退出访谈。结论：本研究结果将有助于确立在零售药房为低功能健康素养患者提供该技术的可行性和实用性。我们将在未来的多地点随机对照试验中收集初步描述性数据，以及方差和效应量测量。公共卫生相关性：由于难以坚持处方药物治疗方案，低功能健康素养的患者往往有较差的结果。我们将使用“会说话的药瓶”（即具有可重录音频容量的药物容器）来记录处方药物说明，以便患者可以根据需要在家中重新播放说明。

DESCRIPTION (provided by applicant): A Pilot Study with Talking Pill Bottles Introduction: Across the healthcare continuum, patients with low functional health literacy may have worse outcomes due to difficulties in following prescribed medication regimens. While reasons for non-adherence can be drawn from the intra-personal, interpersonal, and systemic perspectives; one starting point is the difficulty that patients have reading and understanding medication instructions on a prescription bottle labels. Labels can provide a vital reminder and decision support aid for patients and healthcare proxies. Yet, skills must be available for reading and understanding the labels. We will utilize "Talking Pill Bottles" to record prescription medication instructions so that patients can re-play the instructions as needed in their homes. Purpose: The aim of this research project is to compare the use of "Talking Pill Bottles" to usual care in patients who have low functional health literacy and who purchase medications for primary hypertension at a retail pharmacy with regard to: a. feasibility of the procedures, b. utility of the equipment, c. medication adherence, d. self efficacy in medication self management, and e. blood pressure control. Design: This novel intervention will be tested within the context of a retail pharmacy in the Pacific Northwest. The pilot test will use a randomized trial design with two research arms. Analysis: Within-group change scores on a self efficacy measure and blood pressures will be examined with the paired t-test; between group measures will also be examined between the two treatment arms. We will also track medication complexity as a potential confounder and conduct semi- structured exit interviews. Conclusion: Results will help establish the feasibility and utility of providing this technology to patients who have low functional health literacy in a retail pharmacy. We will gather preliminary descriptive data along with variance and effect size measures for power estimations in a future multi-site, randomized controlled trial. PUBLIC HEALTH RELEVANCE: Patients with low functional health literacy often have worse outcomes due to difficulties in adhering to prescribed medication regimens. We will utilize "Talking Pill Bottles" (i.e., medication containers with re-recordable audio capacity) to record prescription medication instructions so that patients can re-play the instructions as needed in their homes.