基于手机应用程序的居家用药管理对肺移植受者依从性及生存质量的影响

The influence of APP-based at-home medication management on compliance and quality of life of lung transplant recipients

目的探讨“肺病与移植管理”App结合1日药盒用药法居家用药管理方案对肺移植受者自我管理、用药依从性及生存质量的影响。方法选取2019年1至6月无锡市人民医院肺移植中心门诊随访的73例肺移植受者进行自我管理、用药依从性及生存质量的问卷调查。成立用药随访管理小组,制订肺移植受者居家用药管理方案。予肺移植受者“肺病与移植管理”APP结合1日药盒用药法居家用药管理方案干预3个月后再次对其进行问卷调查,比较干预前后受者自我管理、自我效能、用药依从性及生存质量差异。采用配对t检验比较“肺病与移植管理”App结合1日药盒用药法居家用药管理方案干预前后肺移植受者自我管理、自我效能、用药依从性和生存质量得分,P<0.05为差异有统计学意义。结果干预3个月后,受者自我管理、认知性症状管理实践、用药依从性、生存质量及生理方面生存质量得分分别为(37±7)、(16±3)、(7.0±1.0)、(154±26)和(77±14)分,均高于干预前[(33±9)、(13±6)、(6.5±1.1)、(141±30)和(67±17)分],差异均有统计学意义(t=-0.609、-3.383、-12.864、-2.818和3.586,P均<0.05)。干预前后受者自我效能、运动锻炼、与医师的沟通、症状管理、疾病共性管理和心理方面生存质量得分差异均无统计学意义(t=-1.972、-0.609、-1.486、-1.747、-1.746和1.487,P均>0.05)。干预前用药依从性好、中和差受者分别有16、41和16例,干预后分别为27、40和6例。结论基于移动健康平台制订的居家用药管理方案可提高肺移植受者自我管理、用药依从性及生理方面的生存质量。

Objective To explore the effects of the application program of"lung disease and transplantation management"App combined with the 1-day medicine box regimen on the self-management,medication compliance and quality of life of lung transplant recipients.Methods Seventy-three lung transplant recipients who were followed up from January to June 2019 in the lung transplant center of Wuxi People′s Hospital were selected to conduct a questionnaire survey on self-management,medication compliance and quality of life.A follow-up medication administration group was established to develop a medication administration program at home for lung transplant recipients.The"lung disease and transplantation management"App combined with the 1-day medicine box regimen method was used to conduct at-home medication management intervention for lung transplant recipients for 3 months,and the questionnaire survey was conducted again to compare the differences in self-management,self-efficacy,medication compliance and quality of life of lung transplant recipients before and after the intervention.The paired t-test was used to compare the scores of self-management,self-efficacy,medication compliance and quality of life of lung transplant recipients before and after the intervention of the"lung disease and transplantation management"App combined with the 1-day medicine box regimen.A P<0.05 was considered statistically significant.Results After the intervention,the scores of self-management,and cognitive symptoms of management practice,medication adherence,quality of life and physical quality of lung recipients were(37±7),(16±3),(7.0±1.0),(154±26)and(77±14),repectively,all higher than before intervention[(33±9),(13±6),(6.5±1.1),(141±30)and(67±17)],the differences were statistically significant(t=-0.609,-3.383,-12.864,-2.818 and-3.586,all P<0.05).There were no statistically significant differences in self-efficacy,exercise,communication with physicians,symptom management,disease common management and psychological quality of life scores(t=-1.972,-0.609,-1.486,-1.747,-1.746 and-1.487,all P>0.05).There were 16,41 and 16 cases of good drug compliance,and 27,40 and 6 cases after intervention,respectively.Conclusions The management plan of home medication based on mobile health platform can improve the self-management,medication compliance and physiological quality of life of lung transplant recipients.