Cross-platform remote monitoring technologies to monitor and improve adherence to

跨平台远程监控技术，用于监控和提高遵守情况

• 批准号: 8445454
• 负责人: Barbara Ann Rapchak
• 金额: $ 44.92万
• 依托单位: LEAP OF FAITH TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-29 至 2014-09-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8445454
• 关键词: Academia; Activities of Daily Living; Adherence; Admission activity; Adoption; Adverse effects; Affect; Age; Aging; American; Americas; Apple; Back; Businesses; Cancer Center; Cancer Patient; Caring; Cellular Phone; Cessation of life; Chronic Disease; Clinical; Clinical Trials; Collaborations; Communication; Computer software; Data; Data Aggregation; Data Display; Devices; Disease; Disease Progression; Dose; Elderly; Event; Expenditure; Focus Groups; Fortune; Fostering; Frequencies; Health Status; Healthcare; Healthcare Industry; Healthcare Systems; Hospitalization; Hospitals; Industry; Informatics; Internet; Journal of the National Cancer Institute; Letters; Life Style; Marketing; Medicine; Monitor; National Institute on Aging; North Carolina; Nursing Research; Oral; Outcome; Patient Care; Patient Outcomes Assessments; Patients; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacy facility; Phase; Philadelphia; Physicians; Pilot Projects; Provider; Publishing; Quality of life; Radio; Randomized Controlled Trials; Relative (related person); Reporting; Research; Robert H Lurie Comprehensive Cancer Center of Northwestern University; Running; Sampling; Schedule; Science; Self Efficacy; Small Business Innovation Research Grant; Solutions; Staging; Symptoms; System; Technology; Testing; Therapeutic; Therapeutic Index; Time; Touch sensation; Toxic effect; United States; Universities; Visit; Wireless Technology; Work; base; behavioral health; clinically significant; college; commercialization; cost; demographics; design; improved; medical supply; medication compliance; preference; prevent; prototype; research and development; success; usability; web interface; web services

DESCRIPTION (provided by applicant): Medication nonadherence is a costly healthcare problem, adding $177 billion annually to the nation's healthcare expenditures. Three out of four Americans do not take their medicine as prescribed, and the ramifications affect virtually every aspect of the health care system. It is called America's other drug problem for good reason. Nonadherence issues are particularly troublesome with oral chemotherapeutic medications, which are increasingly entering the market, and which often have severe toxicities and narrow therapeutic indices. A review of adherence published in the Journal of the National Cancer Institute found that up to 80 percent of cancer patients failed to follow their prescriptions. There is not a "one size fits all" solution to the adherence problem. Thus, this Fast Track application aims to facilitate widespread adoption of promising telemonitoring technology for improving medication adherence by extending it to additional wireless platforms to make it accessible to broad sociodemographic groups. It fosters partnerships among collaborators from academia, healthcare, and industry working together toward this aim. The proposed RandD would enable us to make very promising technology available to more people who could benefit from it by acknowledging their age, lifestyle, disease state, and preference for a particular communication strategy and platform. The existing technology was developed through a Small Business Innovation Research (SBIR) grant from the National Institute on Aging. It integrates cell phones, radio frequency identification (RFID), and health and behavioral informatics to optimize medication compliance, track medication use, and extend patient care to the ambulatory setting. It has consistently demonstrated adherence rates of 96 percent to 98 percent, along with clinically significant improvements in self efficacy, in randomized control studies among elderly chronic disease and cancer patients taking from 1 to 11 medications/day. Usability testing was conducted by an independent third party at NCI's User-Centered Informatics Research Lab with outstanding success. Patients reported that the technology makes them feel more confident that they will be able to manage their medications. Clinicians participating in the usability testing gave the clinical interface and Web service high marks, calling it "a great boon for the research nurse or clinical trial coordinator." We will extend the existing telemonitoring technology, which runs on a cellphone/PDA, to three new platforms: a low-cost smartphone, the Apple iPhone, and an Internet appliance called Chumby. Work will proceed through six stages. In Phase I we will: (1) develop functional prototypes on three new platforms (2) conduct focus groups to evaluate acceptance by patient end-users, and end-user demographics relative to preference for a particular platform. In Phase II we will: (3) develop full functionality on three new platforms based on focus group input (4) integrate and aggregate adherence and patient reported outcomes data from all platforms through a single web service and user interface (5) conduct a pilot study to demonstrate technical feasibility and assess usability and efficacy (6) assess acceptance of the web service and clinical interface among a sample of clinicians, physicians, providers, and stakeholders in the pharmaceutical supply chain.

描述（由申请人提供）：不遵守药物是一个昂贵的医疗保健问题，每年为美国的医疗保健支出增加1770亿美元。四分之三的美国人没有按照处方服用药物，而后果实际上会影响医疗保健系统的各个方面。这被称为美国的另一个毒品问题，这是有充分理由的。口服化学治疗药物越来越多地进入市场，通常具有严重的毒性和狭窄的治疗指数，因此不遵守问题尤其麻烦。在《国家癌症研究所杂志》上发表的依从性的评论发现，多达80％的癌症患者未能遵循他们的处方。对于依从性问题而言，没有“一个尺寸适合所有尺寸”解决方案。因此，这种快速的应用程序旨在通过将其扩展到其他无线平台，使广泛的社会人口统计学组可访问有前途的远程监控技术，以扩大有希望的远程监控技术来改善药物依从性。它促进了学术界，医疗保健和行业共同努力的合作者之间的合作伙伴关系。拟议的兰德将使我们能够为更多的人提供非常有前途的技术，这些人可以通过承认自己的年龄，生活方式，疾病状态以及对特定的交流策略和平台的偏爱来从中受益。现有技术是通过美国国家老化研究所的小型企业创新研究（SBIR）赠款开发的。它整合了手机，射频识别（RFID）以及健康和行为信息学，以优化药物合规性，跟踪药物使用并将患者护理扩展到门诊环境。在老年慢性疾病和癌症患者每天服用的随机对照研究中，它始终显示出96％至98％的依从率，以及自我效能的临床显着提高。可用性测试是由NCI以用户为中心的Informatics Research Lab的独立第三方进行的，并取得了杰出的成功。患者报告说，这项技术使他们更有信心，他们能够管理自己的药物。参加可用性测试的临床医生为临床接口和Web服务提供了高标记，称其为“研究护士或临床试验协调员的巨大福音”。我们将将在手机/PDA上运行的现有远程监控技术扩展到三个新平台：低成本智能手机，Apple iPhone和一个名为Chumby的Internet设备。工作将在六个阶段进行。在第一阶段，我们将：（1）在三个新平台（2）进行焦点组上开发功能原型，以评估患者最终用户的接受，以及最终用户人口统计学相对于特定平台的偏好。在第二阶段我们将：（3）基于焦点小组的输入（4）在三个新平台上开发完整的功能（4）通过单个网络服务和用户界面（5）进行了一项试验研究，以整合和汇总依从性和患者报告的结果，从药物供应链。