Improvement of medication adherence in osteoporosis through telemedicine combined with email: a patient-reported experience and outcome measure-based prospective study.

IF 4.4 Q1 HEALTH CARE SCIENCES & SERVICES
Gherardo Mazziotti, Benedetta Pongiglione, Flaminia Carrone, Michela Meregaglia, Alessandra Angelucci, Maria Laura Costantino, Andrea Aliverti, Andrea Gerardo Antonio Lania, Amelia Compagni
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Abstract

Objectives: To evaluate whether adherence to oral bisphosphonate in patients with osteoporosis may be improved by teleconsultation (TC) with or without combined use of email to contact the bone specialist on-demand (enhanced TC).

Methods: 103 naïve patients with osteoporosis were prescribed branded alendronate (70 mg weekly) and randomised to three service modalities (presence, TC and enhanced TC), and evaluated for medication adherence after 12 months of follow-up. Patients allocated to the enhanced TC were provided with the opportunity to contact the bone specialists by email without any restriction. Patient-reported outcome(PROMs) and experience measures (PREMs) were evaluated with respect to the service modality.

Results: Of 89 patients who were persistent to therapy, 66% displayed optimal medication adherence, with odds being 4.5 higher in patients receiving enhanced TC versus those receiving the other services. TC service modality was considered in general to be worse in quality than in presence visits, whereas the combination with email use as in enhanced TC was sufficient to compensate for the perceived decrease in quality of care. Enhanced TC did not have any impact on the perception of quality of life as assessed by PROMs.

Discussion: In patients with osteoporosis, TC did not provide any advantage over traditional in presence visits in terms of improvement of adherence to therapy. However, when TC was combined with email to contact the bone specialist on demand, there was a significant improvement in adherence to the prescribed drug.

Conclusions: Patients with osteoporosis need to be supported after drug prescription to guarantee optimal medication therapy.

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通过远程医疗结合电子邮件改善骨质疏松症患者的药物依从性:一项患者报告的经验和基于结果测量的前瞻性研究。
目的:评估骨质疏松症患者口服双膦酸盐的依从性是否可以通过远程会诊(TC)与或不结合使用电子邮件按需联系骨骼专家(增强TC)来改善。方法:103例naïve骨质疏松患者给予品牌阿仑膦酸钠(每周70 mg),随机分为三种服务模式(存在、TC和强化TC),随访12个月后评估药物依从性。分配到增强TC的患者有机会通过电子邮件联系骨骼专家,不受任何限制。患者报告的结果(PROMs)和经验措施(PREMs)就服务方式进行评估。结果:在89名坚持治疗的患者中,66%的患者表现出最佳的药物依从性,接受强化TC治疗的患者与接受其他治疗的患者的赔率高出4.5。一般认为,TC服务方式的质量比现场访问差,而在增强TC中结合使用电子邮件足以弥补护理质量的下降。增强的TC对PROMs评估的生活质量感知没有任何影响。讨论:在骨质疏松患者中,TC在改善治疗依从性方面没有提供任何优于传统就诊的优势。然而,当TC结合电子邮件联系骨骼专家的需求时,对处方药的依从性有了显著的改善。结论:骨质疏松患者需在药物处方后给予支持,以保证最佳的药物治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
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