Mobile Phone Application to Increase Tobacco Cessation Medication Adherence

手机应用程序可提高戒烟药物的依从性

• 批准号: 8249311
• 负责人: JUDITH SARAH GORDON
• 金额: $ 19.94万
• 依托单位: C/J MEDIA, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-18 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8249311
• 关键词: Address; Adherence; Adult; Adverse effects; African American; Apple; Asthma; Attitude; Belief; Bupropion; Car Phone; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chantix; Chronic; Communication; Data; Development; Diabetes Mellitus; Disease; Dose; Effectiveness; Elements; Enrollment; Ensure; Evidence based treatment; Feedback; Focus Groups; Glosso-Sterandryl; Health; Health Care Costs; Health Personnel; Health Planning; Hospitalization; Hyperlipidemia; Hypertension; Income; Internet; Learning; Mails; Marketing; Medical; Nicotine Inhaler; Nicotine Nasal Spray; Online Systems; Outcome; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Pharmacists; Phase; Physicians; Prevalence; Procedures; Provider; Public Health; Questionnaires; Recruitment Activity; Regimen; Reminder Systems; Reporting; Schedule; Site; Smoker; Surveys; Technology; Telephone; Testing; Text; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Treatment Effectiveness; Treatment outcome; United States; Withholding Treatment; Woman; base; compliance behavior; design; diaries; experience; health application; improved; innovation; medication compliance; men; nicotine patch; nicotine replacement; pharmacy benefit; programs; prototype; quitline; randomized trial; response; satisfaction; social; usability; varenicline; web interface

DESCRIPTION (provided by applicant): Tobacco is the leading cause of preventable disease and death in the U.S. Although effective tobacco cessation medications exist, the impact of these medications is diminished by lack of adherence by the patient. Based on our team's expertise in the use of technology to improve evidence-based treatment of tobacco dependence and improving asthma medication adherence, we propose to develop and evaluate an interactive mobile health application (app) for helping smokers to properly use tobacco cessation medication. Over 85% of U.S. adults use a mobile phone, and 35% of those have apps on their phones. Although our project will focus on tobacco cessation medication, this app would have broad applicability beyond tobacco cessation treatment. Non-adherence to treatment for chronic conditions such as hypertension, hyperlipidemia, and diabetes has been associated with poor treatment outcomes, including increasing hospitalization rates and health care costs. The lessons learned in the proposed project could be applied to the development of mobile health apps for other types of medication. During Phase I, we will design, program and evaluate a prototype mobile health application for the Apple iPhone platform that will assist smokers who are prescribed Chantix(R) (vareniciline) for treatment of tobacco dependence to properly adhere to the medication regimen. The app will include modules aimed at addressing the most common reasons for medication non-adherence (e.g., forgetfulness, poor patient-provider communications, side effects, lack of belief in benefits of medication, etc.). Examples of modules include reminder systems (to prompt dosing and refills), direct linkage from the user to their prescribing physician or pharmacist (to discuss dosing schedule or side effects), and in-depth information about the effectiveness of varenicline and managing side effects. We will use 20 focus group participants to refine the application's interface, functions, and content. We will conduct usability testing with 10 participants to assist in improving the app's functionality and suitability. Finally, we will conduct a test of the app's feasibility and user acceptability with 20 participants. A within-subjects design will evaluate participants' reported usability and satisfaction with the product, users' reported adherence to varenicline, and their actual use of the mobile app. Adherence outcomes will be evaluated using a multi-modal approach, including rate of prescription refills, mobile app collected diary data, and self-report questionnaires. We will assess attitudes and user satisfaction via a mobile-web interface. Program use will be collected automatically via the mobile app. Participants will be assessed at baseline and 12-weeks post-enrollment. During Phase II, we will expand the application platform (e.g., Android and Blackberry) and content (e.g., other prescription tobacco cessation medications and over- the-counter nicotine replacement products), and evaluate the full application via a randomized trial. The final mobile health app will be marketed to smokers, health care providers, health plans (private and employer- based), pharmacy benefit managers, and tobacco quit lines through multiple channels, including the App Store, web-based tobacco cessation programs, Google Ads, social media sites, direct mail and phone. PUBLIC HEALTH RELEVANCE: The prevalence of tobacco use in the United States presents a critical public health issue. The use of medications to assist smokers with quitting is increasing. However, the effectiveness of this treatment is predicated on its proper use. The proposed study seeks to increase the adherence to tobacco cessation medication by developing and evaluating an interactive mobile phone health application.

描述（由申请人提供）：烟草是美国可预防疾病和死亡的主要原因。尽管存在有效的戒烟药物，但由于患者缺乏依从性，这些药物的影响会减弱。基于我们团队在使用技术改善烟草依赖循证治疗和提高哮喘药物依从性方面的专业知识，我们建议开发和评估交互式移动健康应用程序 (app)，以帮助吸烟者正确使用戒烟药物。超过 85% 的美国成年人使用手机，其中 35% 的手机上装有应用程序。尽管我们的项目将重点关注戒烟药物，但该应用程序除了戒烟治疗之外还有广泛的适用性。不坚持治疗高血压、高脂血症和糖尿病等慢性病与治疗结果不佳有关，包括住院率和医疗费用增加。拟议项目中吸取的经验教训可以应用于开发其他类型药物的移动健康应用程序。在第一阶段，我们将为 Apple iPhone 平台设计、编程和评估原型移动健康应用程序，该应用程序将帮助接受 Chantix(R)（瓦伦西林）治疗烟草依赖的吸烟者正确遵守药物治疗方案。该应用程序将包括旨在解决药物不依从性的最常见原因（例如健忘、患者与提供者沟通不畅、副作用、对药物益处缺乏信心等）的模块。模块的示例包括提醒系统（提示给药和补充）、用户与其处方医师或药剂师的直接联系（讨论给药方案或副作用）以及有关伐尼克兰有效性和管理副作用的深入信息。我们将使用 20 名焦点小组参与者来完善应用程序的界面、功能和内容。我们将与 10 名参与者进行可用性测试，以协助改进应用程序的功能和适用性。最后，我们将与20名参与者一起对应用程序的可行性和用户可接受性进行测试。受试者内设计将评估参与者报告的产品可用性和满意度、用户报告的伐尼克兰依从性以及他们对移动应用程序的实际使用情况。将使用多模式方法评估依从性结果，包括处方补充率、移动应用程序收集的日记数据和自我报告问卷。我们将通过移动网络界面评估态度和用户满意度。计划使用情况将通过移动应用程序自动收集。参与者将在基线和注册后 12 周接受评估。在第二阶段，我们将扩展应用平台（例如Android和黑莓）和内容（例如其他处方戒烟药物和非处方尼古丁替代产品），并通过随机试验评估完整的应用程序。最终的移动健康应用程序将通过多种渠道（包括 App Store、基于网络的戒烟计划、Google）向吸烟者、医疗保健提供者、健康计划（私人和雇主）、药品福利管理者和戒烟热线进行营销。广告、社交媒体网站、直邮和电话。 公共卫生相关性：美国烟草使用的盛行提出了一个重要的公共卫生问题。帮助吸烟者戒烟的药物的使用正在增加。然而，这种治疗的有效性取决于其正确使用。拟议的研究旨在通过开发和评估交互式手机健康应用程序来提高戒烟药物的依从性。