电子药盒和手机微信APP的应用对肺结核患者服药依从性的效果评价

doi:10.3969/j.issn.1000-6621.2019.09.009

摘要/Abstract

摘要：

目的评价智能化电子药盒和手机微信APP督导服药管理工具的应用对结核病患者服药依从性的效果。方法自2017年10月3日至2018年3月15日,中国疾病预防控制中心结核病预防控制中心按照目的抽样的方法纳入黑龙江省绥化市的安达市、兰西县和山东省济南市的长清区、济阳县作为研究现场,对4个研究县(区)内2017年9月1日起新登记的234例初治活动性肺结核患者,按照登记顺序及入选标准进行筛选,134例符合纳入标准。将73例符合入选标准的患者中,有智能手机且能够在服药期内(6个月内)保持在线、愿意使用手机微信APP提醒服药的40例患者纳入手机微信APP组;将没有智能手机或有智能手机的94例患者中,愿意使用电子药盒服药提醒的80例纳入电子药盒组。对入选的两组患者进行6个月的前瞻性督导服药管理。采用SPSS 17.0软件对两组患者不同治疗月份的服药率和规则服药依从率进行趋势卡方检验,以P<0.05为差异有统计学意义。结果两组患者观察期间,有34例患者退组,总退组率为28.3%(34/120),其中电子药盒组29例,手机微信APP组5例;电子药盒组另有10例患者服药数据不全。电子药盒组和手机微信APP组患者在服药观察6个月末时有效观察患者分别为41例和35例。两组患者不同月份服药率均在93.0%以上,且随着治疗月序的增加,服药率在电子药盒组[97.5%(1025/1051)~93.3%(1110/1190)]和手机微信APP组[99.5%(994/999)~94.4%(1018/1078)]均有所下降( $χ 趋势 2$ 值分别为11.868、82.921;P值分别为0.001、0.000)。电子药盒组有效观察患者总体规则服药率为85.4%(35/41),手机微信APP组为91.4%(32/35)。结论手机微信APP和电子药盒督导服药管理方式对患者服药率和依从性均较好,可扩大范围推广。

关键词: 结核, 肺, 药物疗法, 病例管理, 结果与过程评价(卫生保健), 手机微信APP, 电子药盒

Abstract:

Objective To evaluate the drug compliance effect of TB patients by application of intelligent electronic medicine box and mobile phone WeChat APP supervision drug management tool.Methods Since October 3,2017 to March 15, 2018, according to the purposive sampling method, Anda City and Lanxi County of Suihua City of Heilongjiang Province, Changqing District and Jiyang County of Jinan City of Shandong Province were selected as the research site by National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention. In accordance with the registration sequence and inclusion criteria for the screening, 134 cases were enrolled in the study among 234 newly registered cases since September 1, 2017. Among the 73 patients who met the inclusion criteria, 40 patients who had smart phones and could stay online during the medication period (6 months) and were willing to use WeChat APP to remind them to take the medication were included in the WeChat APP group. Of the 94 patients who did not have smart phones or had smart phones, but willing to use the medicine monitor, 80 pationts who were willing to use the medicine monitor for medication reminder were included in the medicine monitor group. Two groups of patients were prospectively monitored and administered medication for 6 months. SPSS 17.0 software was used to conduct trend Chi-square test on the drug taking rate and regular drug compliance rate of patients in different treatment months in the two groups. P<0.05 was considered as statistically significant difference.Results During the observation period, 34 patients in the two groups withdrew, and the withdrawal rate was 28.3% (34/120), in which 29 patients in the medicine monitor group and 5 patients in the WeChat APP group in addition to 10 patients in the medicine monitor group with incomplete medication data. At the end of 6 months, 41 and 35 patients in the medicine monitor group and WeChat APP group were observed effectively. The drug taking rate of the two groups was more than 93.0% in different months, while the drug taking rate decreased as the treatment month increased, the drug taking rate in the medicine monitor group (97.5% (1025/1051)-93.3% (1110/1190)) and the WeChat APP group (99.5% (994/999)-94.4% (1018/1078)). $χ trend 2$ were 11.868 and 82.921, P values were 0.001 and 0.000 respectively. The overall regular medication rate was 85.4% (35/41) among the effective observation cases of the medicine monitor group and 91.4% (32/35) in the WeChat APP group.Conclusion The supervision medication management mode of WeChat APP and medicine monitor have good effect on the medication rate and compliance of patients, which can be rolled out.

Key words: Tuberculosis, pulmonary, Drug therapy, Case management, Outcome and process assessment (health care), Mobile phone WeChat, Medicine monitor

李雪,姜世闻,胡冬梅,徐彩红,刘小秋. 电子药盒和手机微信APP的应用对肺结核患者服药依从性的效果评价[J]. 中国防痨杂志, 2019, 41(9): 957-961. doi: 10.3969/j.issn.1000-6621.2019.09.009

Xue LI,Shi-wen JIANG,Dong-mei HU,Cai-hong XU,Xiao-qiu LIU. The application of electronic medicine box and mobile phone WeChat APP on the effect of drug compliance in tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2019, 41(9): 957-961. doi: 10.3969/j.issn.1000-6621.2019.09.009

图/表 1

表1

两组有效观察患者不同月序的服药率情况

治疗月序	电子药盒组(41例)			手机微信APP组(35例)
治疗月序	应服药次数	实际服药次数	服药率(%)	应服药次数	实际服药次数	服药率(%)
第1个月	1051	1025	97.5	999	994	99.5
第2个月	1084	1047	96.6	1002	995	99.3
第3个月	1057	989	93.6	1021	1001	98.0
第4个月	1132	1092	96.5	999	949	95.0
第5个月	1186	1149	96.9	1040	986	94.8
第6个月	1190	1110	93.3	1078	1018	94.4
合计	6700	6412	95.7	6139	5943	96.8
$χ 趋势 2$ 值			11.868			82.921
P值			0.001			0.000

表1

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