哮喘联盟

   摘要
   目的：导致哮喘患者药物治疗依从性低的一个常见原因是忘记服药。短信、自动电话呼叫和视听提醒装置形式的每日药物提醒系统可能能解决这个问题。本综述旨在评估提醒系统对患者每日哮喘治疗依从性的影响。
   方法：我们进行了文献系统回顾，以选出评估提醒系统对每日哮喘治疗依从性影响的随机对照试验研究(RCTs)。我们查阅了2013年5月份Pub Med (MEDLINE), CINAHL, EMBASE, PsychINFO和Cochrane Library发表的所有英文文章。我们提取了以下数据：研究发表的年份、地点、纳入和剔除标准、患者特征、提醒系统特征、对患者依从率的影响及其他测量结果。采用描述性统计方法对研究特征和结果进行总结。
   结果：共分析5项RCTs和1项务实的RCT纳入分析。中位随访时间为16周。6项研究表明使用提醒系统干预的受试者其哮喘治疗依从性高于对照组。无研究纪录了哮喘相关生活质量或临床哮喘结局的变化。
   结论：我们分析的所有研究都提示提醒系统能增加患者的治疗依从性，但是无研究表明其能改善临床结局。需要进行更长期的干预研究来评估其对临床结局的影响，及对患者依从性影响的持续性。
 

（刘国梁 审校）
J Asthma. 2014 Feb 13. [Epub ahead of print]

 

Patient reminder systems and asthma medication adherence: a systematic review.
 

Tran N, Coffman JM, Sumino K, Cabana MD.


ABSTRACT
OBJECTIVE: One of the most common reasons for medication non-adherence for asthma patients is forgetfulness. Daily medication reminder system interventions in the form of text messages, automated phone calls and audiovisual reminder devices can potentially address this problem. The aim of this review was to assess the effectiveness of reminder systems on patient daily asthma medication adherence.
METHODS: We conducted a systematic review of the literature to identify randomized controlled trials (RCTs) which assessed the effect of reminder systems on daily asthma medication adherence. We searched all English-language articles in Pub Med (MEDLINE), CINAHL, EMBASE, PsychINFO and the Cochrane Library through May 2013. We abstracted data on the year of study publication, location, inclusion and exclusion criteria, patient characteristics, reminder system characteristics, effect on patient adherence rate and other outcomes measured. Descriptive statistics were used to summarize the characteristics and results of the studies.
RESULTS:  Five RCTs and one pragmatic RCT were included in the analysis. Median follow-up time was 16 weeks. All of the six studies suggested that the reminder system intervention was associated with greater levels of participant asthma medication adherence compared to those participants in the control group. None of the studies documented a change in asthma-related quality of life or clinical asthma outcomes.
CONCLUSION: All studies in our analysis suggest that reminder systems increase patient medication adherence, but none documented improved clinical outcomes. Further studies with longer intervention durations are needed to assess effects on clinical outcomes, as well as the sustainability of effects on patient adherence.
 

J Asthma. 2014 Feb 13. [Epub ahead of print]