摘要
目的评估一款具有服药提醒功能的智能手表对心房颤动(房颤)患者口服抗凝药物(OAC)依从性的影响。方法将2018年10月至2019年12月来自6家医疗中心的210例正在接受OAC治疗的房颤患者随机数字抽样法分为标准随访组和智能手表提醒随访组。标准随访组通过随访护士进行电话及门诊随访,智能手表提醒随访组在标准随访的基础上,还通过一款智能手表进行随访。该手表具备每日服药提醒、漏服报警、上传反馈功能,未按时服药时会将信息反馈至随访终端,由随访护士人工电话督促服药。通过Morisky用药依从性问卷(MMAS-8)及药片计数法[服药天数所占比例(PDC)法]评价药物依从性。药物依从性良好的定义为MMAS-8问卷评分=8分或PDC≥80%。所有患者均随访12个月。比较两组MMAS-8及PDC法计算患者药物依从性。结果标准随访组MMAS-8评分=8分的比例由第1个月时的82.9%下降到第12个月时的27.8%;智能手表提醒随访组MMAS-8评分=8分的比例从第1个月时的75.2%提高至第12个月时的86.3%。从第7个月开始,智能手表提醒随访组的MMAS-8评分=8分的比例显著高于标准随访组(66.7%对51.0%,P=0.025)。标准随访组PDC≥80%的比例从第1个月时的72.4%降至第12个月时的16.7%;而智能手表提醒随访组每个月的PDC≥80%的患者比例均超过90%,且随访期间均高于标准随访组(P<0.001)。结论智能手表服药提醒辅助随访可以持续改善房颤患者OAC治疗的依从性。
Objective To evaluate the effects of a smart watch with medication reminders on long-term oral anticoagulation(OAC)adherence in patients with atrial fibrillation(AF).Methods From October 2018 to December 2019,our studies were performed in 6 medical centers,210 patients with AF who were prescribed long-term OAC therapy were randomly divided into 2 groups(using random sampling method):the standard care group and the smart watch reminder group.Both groups received regular follow-up calls,and were scheduled for outpatient visits.In the smart watch reminder group,OAC adherence was also ensured by a smart watch with daily intake reminders,an intake error(including delayed or missed doses)alarm,as well as an immediate telephone feedback function.The Morisky medication adherence scale(MMAS-8),a self-reported adherence measure,and the proportion of days covered(PDC),an objective measure,were used to evaluate adherence to OAC therapy.Adherence to treatment was defined as a score of 8 on MMAS-8 or as a PDC cutoff of≥80%.All patients were followed up 12 months.Results In the standard care group,the proportion with an MMAS-8 score of 8 decreased from 82.9%in the first month to 27.8%in the twelfth month.In the smart watch reminder group,the proportion with an MMAS-8 score of 8 increased from 75.2%in the first month to 86.3%in the twelfth month.From the 7th month onwards,the proportion of MMAS-8 score=8 in the smart watch reminder group was significantly higher than that in the standard follow-up group(66.7%vs.51.0%,P=0.025).The proportion of PDC≥80%in the standard follow-up group decreased from 72.4%at the first month to 16.7%at the 12th month.The percentage of patients with PDC≥80%in the smart watch reminder group was more than 90%every month,and was higher than that of the standard care group(P<0.001).Conclusion The compliance of AF patients to OAC treatment can be continuously improved through smart watch assistance during follow-up.
作者
陈汝明
史展
卢晓英
张宇
王凤楠
王春慧
陆艳
李慧
李婷
田颖
刘兴鹏
Chen Ruming;Shi Zhan;Lu Xiaoying;Zhang Yu;Wang Fengnan;Wang Chunhui;Lu Yan;Li Hui;Li Ting;Tian Ying;Liu Xingpeng(Heart Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Heart Center,Beijng Hospital,Beijing 100730,China;Heart Center,Hebei Yanda International Hospital,Sanhe 065201,China;Heart Center,Cilin Hospital,Ningbo 315315,China;Heart Center,Benq Hospital,Suzhou 215011,China;Heart Center,Sunshine Union Hospital,Weifang 261072,China;Heart Center,Shijiazhuang Changcheng Hospital,Shijiazhuang 050035,China)
出处
《中华心律失常学杂志》
2022年第3期272-276,共5页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
口服抗凝药
药物依从性
智能手表
Atrial fibrillation
Oral anticoagulation
Drug adherence
Smart watch
