SCH:INT: Collaborative Research: Multiscale Modeling and Intervention for Improving Long-Term Medication

SCH:INT：协作研究：改善长期用药的多尺度建模和干预

• 批准号: 10411414
• 负责人: Laura Elizabeth Barnes
• 金额: $ 6.13万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10411414
• 关键词: Adherence; Behavior; Behavioral; Breast Cancer survivor; Cellular Phone; Cognitive; Data; Environmental Risk Factor; Event; Fibrinogen; In Situ; Intervention; Life; Link; Malignant Neoplasms; Modeling; Monitor; Oral; Patients; Pattern; Pharmaceutical Preparations; Phase; Public Health; Research; SMART health; Savings; Study Subject; Survivors; System; Technology; Wireless Technology; Work; adherence rate; base; cancer recurrence; chemotherapy; connected health; experience; forgetting; hormone receptor-positive; hormone therapy; human subject; improved; malignant breast neoplasm; medication compliance; multi-scale modeling; personalized intervention; prevent; sensor; tool; wearable sensor technology

By 2022, there will be nearly 4 million breast cancer survivors in the USA. Adherence to long-term endocrine therapy is crucial for survivors of hormone receptor-positive breast cancer prescribed these daily medications to prevent cancer recurrence. Despite the life-saving benefits of these medications, rates of adherence are low. Medication-taking behavior is simultaneously influenced by multiscale factors, including personal and environmental factors, and a patient's other behavioral patterns. Despite advances in smart and connected health, there have been few attempts to develop and deliver personalized interventions for medication adherence. Existing technology-based interventions focus on cognitive reasons for non-adherence to medications experienced by some people (e.g., forgetting), but fail to account for interactions between cognitive factors and other types of factors (i.e., environmental, behavioral) that contribute to adherence. Furthermore, few technology-driven interventions have been assessed for efficacy in supporting medication adherence. Tools to understand interactions between multiscale factors and the effect that personalized interventions have on these factors would ultimately improve medication adherence. This 3-phase project will overcome these fundamental scientific barriers by developing and employing a Multiscale Modeling and Intervention (MMI) system. First, a system consisting of sensor-rich smartphones, wireless medication event monitoring systems (MEMS), wireless beacons, and wearable sensors that collect in situ data on medication adherence, will be developed to provide continuous, noninvasive adherence assessment and multiscale monitoring of factors. Second, the MMI system will be deployed to breast cancer survivors to model relationships between adherence and multiscale factors, identify patterns associated with medication-taking behavior, and develop interventions. Third, a proof-of-concept for MMI will be demonstrated through a human subjects study, with subjects receiving multiscale interventions. The proposed research has significant public health implications as it is expected to increase our understanding of medication adherence in breast cancer survivors, thus providing a general framework that will be applicable to oral chemotherapy use across multiple cancers.

到2022年，美国将有近400万乳腺癌幸存者。长期遵守 内分泌治疗对于激素受体阳性乳腺癌的幸存者至关重要 预防癌症复发的药物。尽管这些药物具有挽救生命的好处，但 依从性很低。服药行为同时受到多尺度因素的影响，包括 个人和环境因素，以及患者的其他行为模式。尽管聪明的进步 以及互联的健康，几乎没有尝试开发和提供个性化干预措施 药物依从性。现有基于技术的干预措施着重于不遵守的认知原因 某些人经历的药物（例如，忘记），但无法解释互动 认知因素和其他类型的因素（即环境，行为）之间有助于 坚持。此外，很少评估以技术为导向的干预措施 支持药物依从性。了解多尺度因素与 个性化干预对这些因素的影响最终会改善药物治疗 坚持。这个三相项目将通过开发和 采用多尺度建模和干预（MMI）系统。首先，一个由传感器富含传感器组成的系统 智能手机，无线药物活动监测系统（MEMS），无线信标和可穿戴 将开发有关药物依从性的原位数据的传感器，以提供连续的，无创的 依从性评估和多尺度监测因素。第二，MMI系统将是 部署到乳腺癌幸存者来建模依从性和多尺度因素之间的关系， 确定与药物治疗行为相关的模式，并制定干预措施。第三，概念验证 因为MMI将通过人类主题研究来证明，受试者接受了多尺度 干预措施。拟议的研究具有重大的公共卫生影响，因为预计将增加 我们对乳腺癌幸存者中药物依从性的理解，从而提供了一个一般框架 这将适用于多种癌症的口服化学疗法使用。