吴密彬,王春青,胡雁,裘佳佳,朱叶卉,陆箴琦,黄嘉玲.基于药物监控平台随访对乳腺癌患者服药依从性的影响[J].上海护理,2018,18(4):
基于药物监控平台随访对乳腺癌患者服药依从性的影响
投稿时间:2016-12-07  修订日期:2018-03-23
DOI:
中文关键词:  乳腺癌  内分泌治疗  药物信念问卷  药物占有比  护士主导随访
英文关键词:breast cancer  endocrine therapy  BMQ  MPR  nurse-led follow -up
基金项目:上海市卫生局局级科研项目(KBF400803);
作者单位邮编
吴密彬 复旦大学 200032
王春青 复旦大学 200032
胡雁 复旦大学 200032
裘佳佳 复旦大学附属肿瘤医院 200032
朱叶卉 复旦大学附属肿瘤医院 200032
陆箴琦 复旦大学附属肿瘤医院 200032
黄嘉玲 复旦大学附属肿瘤医院 200032
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中文摘要:
      目的 评价基于内分泌服药监控平台的护士主导随访对乳腺癌患者的服药信念和服药依从性的效果。方法 通过随访期为24个月的前瞻性随机对照试验,采用重复测量的方差分析比较干预组和对照组在共311名患者在基线、干预后3个月、6个月、18个月、24个月服药信念量表的得分、服药依从性视觉模拟量表评分、以及药物占有比值。结果 重复测量方差分析结果显示,服药信念量表中顾虑性维度及总分不存在显著的差异,必要性维度存在显著时间*组别间的交互效应,在6个月、18个月时,干预组的药物信念量表必要性维度得分较对照组有显著提高。干预组的服药依从性视觉模拟量表评分、药物占有比值分别在6个月、18个月较对照组显著提高。 结论 通过基于药物监控平台的护士主导随访包括续药提醒、电话随访、药物咨询以及副作用应对策略指导和转介等,可以提高乳腺癌术后辅助内分泌治疗患者的服药依从性。
英文摘要:
      Objective To assessment the effectiveness nurse-led follow-up instead of hospital visits on medication adherence and medication belief in the 24 months duration for breast cancer patients with hormonal therapy. Methods A randomized controlled trial (RCT) design was performed among 311 early breast cancer patients with hormonal therapy. A self-design web-database medication monitoring platform was designed for managing the patients such as texting, reminding and mailing. Participants were randomized to follow-up care as usual (yearly outpatient clinic visits) or nurse-led telephone follow-up (monthly consultation with structured intervention). Telephone follow-up was performed by four trained breast-care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy side-effects, compliance with hormonal therapy and an open discussion of these issues. The primary outcome for interventions was measured by Beliefs about Medicines Questionnaire (BMQ), VAS adherence score, and Medication Possession Ratio (MPR). Results Significant difference was seen in necessity subscale score (p>0.05) at 3, 6, and 18 months respectively. Significant differences were also indicated in VAS medication adherence score and MRP at 6 and 18 months. Conclusions Nurse-led follow up based on medication monitoring platform appears to be effective in improving medication adherence.
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