Telehealth behavioral treatment for medication nonadherence: a pilot and feasibility study.
薬物非付着のTelehealth行動治療：パイロットと事前調査。
Eur J Gastroenterol Hepatol. 2013; 25; 469-473;
aDivision of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center bDepartment of Pediatrics, University of Cincinnati College of Medicine cDivision of Gastroenterology, Hepatology and Nutrition, Schubert-Martin Inflammatory Bowel Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio dChildren's Mercy Hospitals and Clinics, Section of Developmental and Behavioral Sciences, Section of Gastroenterology eKansas City School of Medicine, University of Missouri, Kansas City, Missouri fDepartment of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Abstract
OBJECTIVE: To evaluate an individually tailored multicomponent nonadherence treatment protocol using a telehealth delivery approach in adolescents with inflammatory bowel disease. METHODS: Nine participants, age 13.71±1.35 years, completed a brief treatment online through Skype. Medication nonadherence, severity of disease, and feasibility/acceptability data were obtained. RESULTS: Adherence increased markedly from 62% at baseline to 91% for mesalamine (δ=0.63), but decreased slightly from 61% at baseline to 53% for 6-mercaptopurine /azathioprine. The telehealth delivery approach resulted in cost savings of $100 in mileage and 4 h of travel time/patient. Treatment session attendance was 100%, and the intervention was rated as acceptable, particularly in terms of treatment convenience. CONCLUSION: Individually tailored treatment of nonadherence through telehealth delivery is feasible and acceptable. This treatment shows promise for clinical efficacy to improve medication adherence and reduce costs. Large-scale testing is necessary to determine the impact of this intervention on adherence and health outcomes.
方法9人の参加者（13.71±1.35歳年齢）は、Skypeによって短い治療をオンラインで完了した。
薬物非付着、疾患の重症度と実現可能性/許容性データは、得られた。
結果付着はメサラミン（δ=0.63）のためにベースラインの62%から91%まで著しく増加したが、6-メルカプトプリン/アザチオプリンのために、ベースラインの61%から53%にわずかに減少した。
遠隔健康送出アプローチは、マイル数と4時間の旅行時間/患者で100ドルのコスト削減に帰着した。
治療セッション出席は100%であった、そして、特に治療便宜に関して、介入は受け入れられると評価された。
結論遠隔健康送出を通しての非付着の個々に手直しされた治療は、可能なおよび受け入れられる。
この治療は、臨床的有効度が薬物付着を改善して、コストを下げる約束を示す。
大規模な試験は、この介入の付着と健康結果への影響を決定するのに必要である。