促进坚持用药的患者-护理人员孪生手机应用程序

NC Tan, CC Goh, Yle Koh, Sfi Tan, D. Ponraj, ZQ Luo
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摘要

服药依从性差(MA)是全球普遍存在的问题。服药依从性评估通常基于量表或药片计数,缺乏可操作性。我们开发了一款名为 "MediEasy "的移动应用程序(App),针对每天服用多种药物的患者,让他们的护理人员参与进来,以提高他们的用药依从性。这项试验性单臂研究旨在确定 MediEasy 应用程序的可行性、可接受性、实用性以及 2 型糖尿病患者及其护理人员的血糖控制情况。20 名年龄在 51 至 70 岁之间、血糖控制不理想(HbA1c>7.5%)的多种族亚裔患者及其护理人员在新加坡一家初级保健门诊部接受了招募。Medieasy 应用程序包含以下主要功能,如服药提醒、嵌入式药物详情、个性化配药选项(如频率和日程配药设置)。护理人员可在配对设备发出警报时提醒错过预定服药时间的患者。85%(17/20)的参与者在整个 4 周内使用了该应用程序,这反映了其可行性;3 人因技术故障或未能遵守协议而退出。该应用程序平均每天启动 2.8 次,显示出足够的实用性。17 名参与者及其护理人员一致认为,该应用程序有助于坚持服药。使用该应用程序 12 周后,他们的平均 HbA1c 下降了 0.2%。研究结果表明,"MediEasy "应用程序具有可行性、实用性和可接受性,使用该应用程序后,血糖控制得到了改善。
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Patient-caregiver twinned mobile phone application to promote medication adherence
Poor medication adherence (MA) is prevalent globally. MA assessment, often based on scales or pill count, lacks actionability. A mobile application (app), MediEasy, targeting patients on multiple daily medications, has been developed to engage their caregivers to enhance their MA. This pilot single-arm study aimed to determine the feasibility, acceptability, utility and glycaemic control of the MediEasy-app by patients with type-2 diabetes mellitus and their caregivers. 20 Multi-ethnic Asian patients aged 51 to 70 years with suboptimal glycaemic control (HbA1c>7.5%) and their caregivers were recruited at a Primary care outpatient clinic in Singapore. The Medieasy app that contains the following major functionalities such as the alerts to take medications, embedded medication details, personalized dosing options (such as frequency and scheduling dosage settings) is twinned to their designated caregivers. The Caregivers can remind the patients who missed the scheduled medication intake when the paired device was alerted. 85% (17/20) of the participants used the app for the entire 4 weeks, reflecting feasibility; 3 dropped out due to technical glitches or failure to adhere to protocol. The app was activated with an average of 2.8 times per day showing adequate utility. The 17 participants and their caregivers agreed that the app supported medication adherence. Their mean HbA1c decreased by 0.2% after 12 weeks of app usage. The results showed feasibility, utility and acceptability of the MediEasy-app, with improved glycaemic control after its usage.
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