J. Med. Internet Res. - A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial.

Tópicos

{ medic(1828) order(1363) alert(1069) }
{ intervent(3218) particip(2042) group(1664) }
{ patient(2315) diseas(1263) diabet(1191) }
{ health(1844) social(1437) communiti(874) }
{ measur(2081) correl(1212) valu(896) }
{ assess(1506) score(1403) qualiti(1306) }
{ data(1714) softwar(1251) tool(1186) }
{ model(2220) cell(1177) simul(1124) }
{ model(2656) set(1616) predict(1553) }
{ time(1939) patient(1703) rate(768) }
{ studi(2440) review(1878) systemat(933) }
{ design(1359) user(1324) use(1319) }
{ use(2086) technolog(871) perceiv(783) }
{ decis(3086) make(1611) patient(1517) }
{ data(1737) use(1416) pattern(1282) }
{ error(1145) method(1030) estim(1020) }
{ search(2224) databas(1162) retriev(909) }
{ model(2341) predict(2261) use(1141) }
{ monitor(1329) mobil(1314) devic(1160) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ sequenc(1873) structur(1644) protein(1328) }
{ take(945) account(800) differ(722) }
{ featur(1941) imag(1645) propos(1176) }
{ perform(1367) use(1326) method(1137) }
{ patient(2837) hospit(1953) medic(668) }
{ data(2317) use(1299) case(1017) }
{ data(3008) multipl(1320) sourc(1022) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ implement(1333) system(1263) develop(1122) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }
{ imag(1057) registr(996) error(939) }
{ imag(2830) propos(1344) filter(1198) }
{ treatment(1704) effect(941) patient(846) }
{ chang(1828) time(1643) increas(1301) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ system(1050) medic(1026) inform(1018) }
{ research(1218) medic(880) student(794) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ first(2504) two(1366) second(1323) }
{ structur(1116) can(940) graph(676) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ bind(1733) structur(1185) ligand(1036) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ motion(1329) object(1292) video(1091) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ control(1307) perform(991) simul(935) }
{ care(1570) inform(1187) nurs(1089) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ import(1318) role(1303) understand(862) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ gene(2352) biolog(1181) express(1162) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ drug(1928) target(777) effect(648) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Nonadherence and medication errors are common among patients with complex drug regimens. Apps for smartphones and tablets are effective for improving adherence, but they have not been tested in elderly patients with complex chronic conditions and who typically have less experience with this type of technology.OBJECTIVE: The objective of this study was to design, implement, and evaluate a medication self-management app (called ALICE) for elderly patients taking multiple medications with the intention of improving adherence and safe medication use.METHODS: A single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS to allow for the personalization of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly assigned patients in the control group received oral and written information on the safe use of their medications and the patients in the experimental group used ALICE for 3 months. Pre and post measures included rate of missed doses and medication errors reported by patients, scores from the 4-item Morisky Medication Adherence Scale (MMAS-4), level of independence, self-perceived health status, and biochemical test results. In the experimental group, data were collected on their previous experience with information and communication technologies, their rating of ALICE, and their perception of the level of independence they had achieved. The intergroup intervention effects were calculated by univariate linear models and ANOVA, with the pre to post intervention differences as the dependent variables.RESULTS: Data were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively). Patients in the experimental group obtained better MMAS-4 scores (P<.001) and reported fewer missed doses of medication (P=.02). ALICE only helped to significantly reduce medication errors in patients with an initially higher rate of errors (P<.001). Patients with no experience with information and communication technologies reported better adherence (P<.001), fewer missed doses (P<.001), and fewer medication errors (P=.02). The mean satisfaction score for ALICE was 8.5 out of 10. In all, 45 of 51 patients (88%) felt that ALICE improved their independence in managing their medications.CONCLUSIONS: The ALICE app improves adherence, helps reduce rates of forgetting and of medication errors, and increases perceived independence in managing medication. Elderly patients with no previous experience with information and communication technologies are capable of effectively using an app designed to help them take their medicine more safely.TRIAL REGISTRATION: Clinicaltrials.gov NCT02071498; http://clinicaltrials.gov/ct2/show/NCT02071498.

Resumo Limpo

ckground nonadher medic error common among patient complex drug regimen app smartphon tablet effect improv adher test elder patient complex chronic condit typic less experi type technologyobject object studi design implement evalu medic selfmanag app call alic elder patient take multipl medic intent improv adher safe medic usemethod singleblind random control trial conduct control experiment group n spain characterist alic specifi base suggest nomin group total patient focus group profession alic design android io allow person prescript medic advic show imag medic packag medic togeth alert multipl remind alert random assign patient control group receiv oral written inform safe use medic patient experiment group use alic month pre post measur includ rate miss dose medic error report patient score item moriski medic adher scale mmas level independ selfperceiv health status biochem test result experiment group data collect previous experi inform communic technolog rate alic percept level independ achiev intergroup intervent effect calcul univari linear model anova pre post intervent differ depend variablesresult data obtain patient control experiment group respect patient experiment group obtain better mmas score p report fewer miss dose medic p alic help signific reduc medic error patient initi higher rate error p patient experi inform communic technolog report better adher p fewer miss dose p fewer medic error p mean satisfact score alic patient felt alic improv independ manag medicationsconclus alic app improv adher help reduc rate forget medic error increas perceiv independ manag medic elder patient previous experi inform communic technolog capabl effect use app design help take medicin safelytri registr clinicaltrialsgov nct httpclinicaltrialsgovctshownct

Resumos Similares

Int J Med Inform - SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. ( 0,845525099377602 )
Health Informatics J - Effects of a computerized decision support system in improving pharmacological management in high-risk cardiovascular patients: A cluster-randomized open-label controlled trial. ( 0,807465591168796 )
BMC Med Inform Decis Mak - Effects of a computerized feedback intervention on safety performance by junior doctors: results from a randomized mixed method study. ( 0,76421847137896 )
Appl Clin Inform - Using real-time alerts for clinical trials: Identifying potential study subjects. ( 0,729771783919452 )
Telemed J E Health - Rural inpatient telepharmacy consultation demonstration for after-hours medication review. ( 0,713140310926966 )
Appl Clin Inform - Effect of EHR user interface changes on internal prescription discrepancies. ( 0,69875111724942 )
Int J Med Inform - Impact of a clinical decision support system for high-alert medications on the prevention of prescription errors. ( 0,696480844709312 )
J Am Med Inform Assoc - Guided medication dosing for elderly emergency patients using real-time, computerized decision support. ( 0,690902850052104 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,690835219814939 )
Appl Clin Inform - Response to medication dosing alerts for pediatric inpatients using a computerized provider order entry system. ( 0,689458460002782 )
Int J Med Inform - Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan. ( 0,683609815883089 )
J Med Syst - Two RFID-based solutions for secure inpatient medication administration. ( 0,683580999544747 )
J Am Med Inform Assoc - Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. ( 0,682780564736185 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,677177638616918 )
Int J Med Inform - Junior doctors' prescribing work after-hours and the impact of computerized decision support. ( 0,676695897194472 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,676543622088164 )
J Am Med Inform Assoc - Overrides of medication-related clinical decision support alerts in outpatients. ( 0,67613404195858 )
Int J Med Inform - The effect of using the health smart card vs. CPOE reminder system on the prescribing practices of non-obstetric physicians during outpatient visits for pregnant women in Taiwan. ( 0,675898372419916 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,675237837016449 )
J Am Med Inform Assoc - Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients. ( 0,674964751290343 )
J. Med. Internet Res. - Physician order entry or nurse order entry? Comparison of two implementation strategies for a computerized order entry system aimed at reducing dosing medication errors. ( 0,674741768287147 )
Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients. ( 0,674390210724288 )
J Am Med Inform Assoc - Clinical decision support for atypical orders: detection and warning of atypical medication orders submitted to a computerized provider order entry system. ( 0,67240894066221 )
J Am Med Inform Assoc - Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes. ( 0,671976077598264 )
BMC Med Inform Decis Mak - Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model. ( 0,671958100688569 )
J Am Med Inform Assoc - Factors contributing to an increase in duplicate medication order errors after CPOE implementation. ( 0,670964661036263 )
J Am Med Inform Assoc - The impact of the heparin-induced thrombocytopenia (HIT) computerized alert on provider behaviors and patient outcomes. ( 0,670229098364253 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,668090773587654 )
J Am Med Inform Assoc - Classification of medication incidents associated with information technology. ( 0,667745944547699 )
Appl Clin Inform - Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. ( 0,66536173324472 )
BMC Med Inform Decis Mak - Development of a context model to prioritize drug safety alerts in CPOE systems. ( 0,665251789946505 )
Comput Methods Programs Biomed - A smart medication recommendation model for the electronic prescription. ( 0,665207540855393 )
Int J Med Inform - Prescription order risk factors for pediatric dosing alerts. ( 0,665062710173233 )
J Am Med Inform Assoc - A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use. ( 0,6645583359494 )
J Am Med Inform Assoc - Evaluating the accuracy of electronic pediatric drug dosing rules. ( 0,664428238066115 )
J. Med. Internet Res. - Ethical principles for physician rating sites. ( 0,664335159860145 )
J Am Med Inform Assoc - Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. ( 0,663664793447003 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,663474108589401 )
Artif Intell Med - Physicians' responses to clinical decision support on an intensive care unit--comparison of four different alerting methods. ( 0,66268127376849 )
J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. ( 0,662594757717235 )
AMIA Annu Symp Proc - A real-time screening alert improves patient recruitment efficiency. ( 0,661714415306739 )
Health Informatics J - Implementation of smart pump technology in a paediatric intensive care unit. ( 0,660814557619415 )
J Am Med Inform Assoc - Prevalence of medication administration errors in two medical units with automated prescription and dispensing. ( 0,660383014516703 )
J Am Med Inform Assoc - A clinical data warehouse-based process for refining medication orders alerts. ( 0,659086043177666 )
J Am Med Inform Assoc - Surveillance of medication use: early identification of poor adherence. ( 0,659076456875271 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,658255582851233 )
Appl Clin Inform - Electronic medical record prompts for lab orders in patients initiating statins. ( 0,656771996774061 )
AMIA Annu Symp Proc - Improving Patient Safety through Medical Alert Management: An Automated Decision Tool to Reduce Alert Fatigue. ( 0,65666900068279 )
J Am Med Inform Assoc - A framework for evaluating the appropriateness of clinical decision support alerts and responses. ( 0,656432528674781 )
J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. ( 0,656051343905685 )
Appl Clin Inform - A trial of inpatient indication based prescribing during computerized order entry with medications commonly used off-label. ( 0,655954277580888 )
Comput Methods Programs Biomed - Physicians' responses to computerized drug-drug interaction alerts for outpatients. ( 0,65495876821001 )
J Med Syst - Developing a web 2.0 diabetes care support system with evaluation from care provider perspectives. ( 0,653937693520992 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,653914546267086 )
J Am Med Inform Assoc - Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients. ( 0,653881300125032 )
Int J Med Inform - Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists' analysis of medication orders in hospitals. ( 0,65197090705318 )
J Am Med Inform Assoc - Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard. ( 0,651748048255172 )
Appl Clin Inform - Understanding interprofessional communication: a content analysis of email communications between doctors and nurses. ( 0,65017381634636 )
AMIA Annu Symp Proc - Reducing wrong patient selection errors: exploring the design space of user interface techniques. ( 0,649839683851811 )
Perspect Health Inf Manag - Enhance the accuracy of medication histories for the elderly by using an electronic medication checklist. ( 0,64803294333361 )
J Am Med Inform Assoc - Development and use of active clinical decision support for preemptive pharmacogenomics. ( 0,647940884951247 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,647613383181645 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,646743836292492 )
Comput Methods Programs Biomed - Developing guideline-based decision support systems using prot?g? and jess. ( 0,644643764595895 )
J Am Med Inform Assoc - Integrating pharmacogenetic information and clinical decision support into the electronic health record. ( 0,642978389208937 )
J. Med. Internet Res. - Understanding patient portal use: implications for medication management. ( 0,642769131761569 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,642735274395387 )
J Am Med Inform Assoc - Failure to utilize functions of an electronic prescribing system and the subsequent generation of 'technically preventable' computerized alerts. ( 0,64146483548702 )
J Med Syst - Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. ( 0,640198378369868 )
Int J Med Inform - A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation. ( 0,640176036624575 )
AMIA Annu Symp Proc - An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals. ( 0,639553100622655 )
Telemed J E Health - Shared care combined with telecare improves glycemic control of diabetic patients in a rural underserved community. ( 0,638489396691731 )
Methods Inf Med - From adverse drug event detection to prevention. A novel clinical decision support framework for medication safety. ( 0,638162762898134 )
J Am Med Inform Assoc - Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. ( 0,638030075296512 )
Artif Intell Med - Safety and usability evaluation of a web-based insulin self-titration system for patients with type 2 diabetes mellitus. ( 0,637731792216726 )
Int J Med Inform - Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents. ( 0,636681187838746 )
J Am Med Inform Assoc - The safety of electronic prescribing: manifestations, mechanisms, and rates of system-related errors associated with two commercial systems in hospitals. ( 0,63358369459388 )
Med Biol Eng Comput - Strategy for NSAID administration to aspirin-intolerant asthmatics in combination with PGE2 analogue: a theoretical approach. ( 0,633502124612848 )
J. Med. Internet Res. - Directed use of the internet for health information by patients with chronic kidney disease: prospective cohort study. ( 0,633231651449654 )
J Am Med Inform Assoc - Online disease management of diabetes: engaging and motivating patients online with enhanced resources-diabetes (EMPOWER-D), a randomized controlled trial. ( 0,632425218786099 )
Med Decis Making - Better medicine by default. ( 0,630952717375424 )
J. Med. Internet Res. - Effects of a Web-based intervention for adults with chronic conditions on patient activation: online randomized controlled trial. ( 0,630304989585736 )
AMIA Annu Symp Proc - I meant that med for Baylee not Bailey!: a mixed method study to identify incidence and risk factors for CPOE patient misidentification. ( 0,629742301646109 )
J Am Med Inform Assoc - Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation. ( 0,62938588622009 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,628612915323746 )
J Am Med Inform Assoc - Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. ( 0,628412981123248 )
AMIA Annu Symp Proc - Improving Medication Adherence in a Regional Healthcare Information Exchange using a Scalable, Claims-Driven, and Service-Oriented Approach. ( 0,626560017023731 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,624423772491619 )
Int J Med Inform - Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process. ( 0,623195713088103 )
Methods Inf Med - Attitude of physicians towards automatic alerting in computerized physician order entry systems. A comparative international survey. ( 0,622389208287141 )
J. Med. Internet Res. - An exploration of social circles and prescription drug abuse through Twitter. ( 0,620987033277299 )
Perspect Health Inf Manag - Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? ( 0,620323079867449 )
J Biomed Inform - The use of sequential pattern mining to predict next prescribed medications. ( 0,61902467174913 )
AMIA Annu Symp Proc - Unexpected effects of unintended consequences: EMR prescription discrepancies and hemorrhage in patients on warfarin. ( 0,61643727080314 )
Appl Clin Inform - Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. ( 0,616393123135884 )
J Am Med Inform Assoc - Detecting pregnancy use of non-hormonal category X medications in electronic medical records. ( 0,614751344236943 )
J Am Med Inform Assoc - Prescribers' expectations and barriers to electronic prescribing of controlled substances. ( 0,612487291761522 )
Appl Clin Inform - Analysis of electronic medication orders with large overdoses: opportunities for mitigating dosing errors. ( 0,612436736446139 )
J Am Med Inform Assoc - Effectiveness of an information technology intervention to improve prophylactic antibacterial use in the postoperative period. ( 0,612249223708626 )
AMIA Annu Symp Proc - Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue. ( 0,611620115715013 )