移动应用程序提高心血管疾病患者的药物依从性:卡塔尔世界杯8强波胆分析系统评价与meta分析%A Al-Arkee,Shahd %A Mason,Julie %A Lane,Deirdre %A Fabritz,Larissa %A Chua,Winnie %A Haque,M Sayeed %A Jalal,Zahraa %+伯明翰大学临床科学研究所，伯明翰，b152tt, 44 0121 414 4042，s.k.k.al-arkee@pgr.bham.ac.uk %K移动医疗应用程序%K药物依从性%K心血管疾病%K系统评价%K手机%D评论%J J Med Internet Res %G英文%X背景:据报道，心血管疾病(CVD)预防性药物的依从率为57%，欧洲约有9%的CVD事件可归因于药物依从性差。移动医疗技术，特别是移动应用程序，有可能改善药物依从性和临床结果。目的:本研究的目的是评估移动医疗应用程序对心血管疾病患者药物依从性和健康相关结局的影响。这项研究还评估了应用程序的功能和可用性，以及医疗保健专业人员在使用过程中的参与度。方法:检索电子数据库(MEDLINE [Ovid]、PubMed Central、Cochrane Library、CINAHL Plus、PsycINFO [Ovid]、Embase [Ovid]和Google Scholar)，研究随机对照试验(RCTs)，以研究基于应用程序的干预措施，旨在改善心血管疾病患者的药物依从性。回顾了从开始到2020年1月以英文发表的随机对照试验。采用Cochrane偏倚风险工具对纳入的研究进行评估。对临床结局和药物依从性进行meta分析，采用meta回归分析评估app干预时间对药物依从性的影响。 Results: This study included 16 RCTs published within the last 6 years. In total, 12 RCTs reported medication adherence as the primary outcome, which is the most commonly self-reported adherence. The duration of the interventions ranged from 1 to 12 months, and sample sizes ranged from 24 to 412. Medication adherence rates showed statistically significant improvements in 9 RCTs when compared with the control, and meta-analysis of the 6 RCTs reporting continuous data showed a significant overall effect in favor of the app intervention (mean difference 0.90, 95% CI 0.03-1.78) with a high statistical heterogeneity (I2=93.32%). Moreover, 9 RCTs assessed clinical outcomes and reported an improvement in systolic blood pressure, diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol levels in the intervention arm. Meta-analysis of these clinical outcomes from 6 RCTs favored app interventions, but none were significant. In the 7 trials evaluating app usability, all were found to be acceptable. There was a great variation in the app characteristics. A total of 10 RCTs involved health care professionals, mainly physicians and nurses, in the app-based interventions. The apps had mixed functionality: 2 used education, 7 delivered reminders, and 7 provided reminders in combination with educational support. Conclusions: Apps tended to increase medication adherence, but interventions varied widely in design, content, and delivery. Apps have an acceptable degree of usability; yet the app characteristics conferring usability and effectiveness are ill-defined. Future large-scale studies should focus on identifying the essential active components of successful apps. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019121385; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=121385 %M 34032583 %R 10.2196/24190 %U //www.mybigtv.com/2021/5/e24190 %U https://doi.org/10.2196/24190 %U http://www.ncbi.nlm.nih.gov/pubmed/34032583