Adherence & HRQOL: Translation of Interventions

依从性

• 批准号: 7534687
• 负责人: JACQUELINE M DUNBAR-JACOB
• 金额: $ 70.23万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-08 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7534687
• 关键词: Adherence; HRQOL; Translation; Interventions

DESCRIPTION (provided by applicant): The program project addresses clinical research studies designed to improve quality of life and delay or slow the progression of chronic conditions through the examination of self-management strategies which target adherence to treatment regimen, thus improving the effectiveness of care, with an overlapping objective of identifying factors necessary for successful translation. Chronic disorder regimens typically include a combination of medication, physical activity, dietary modification, and other lifestyle adjustments. Documented treatment effectiveness in the range of 30- 40% is not surprising given that adherence to prescribed treatment has been estimated at approximately 50%. The poor outcomes related to problems in the management of treatment regimens are a costly burden to patients, their caregivers, and the healthcare systems alike. The projects proposed in this application will examine interventions directed to the individual, the caregiver, or the health care provider. The projects will collect a common dataset to facilitate translation of interventions, including potential predictors of response; time to deliver interventions; training time for interventionists; acceptability of intervention to participants; and, quality of intervention delivery. Core assessments will be made available for pooling of data. Four projects are included in this program project proposal. Project 1 will examine a habit-training intervention capitalizing on automatic processes to improve medication adherence and to identify patients at risk of non-adherence. Project 2 will conduct a randomized controlled trial to examine the ability of self-efficacy to enhance adherence to lifestyle change therapy; as well as the role of self-efficacy and/or optimism in adherence to dietary and exercise changes. Project 3 will evaluate the effectiveness of a single-modality adherence intervention based on Concordance Therapy delivered by primary care nurses in a racially diverse sample of primary care patients with unipolar depression and comorbid diabetes mellitus or hypertension; this study will also evaluate whether improvement in adherence to antidepressant therapy is associated with improvement in adherence to oral medications for diabetes or hypertension. Project 4 will test a tailored medication management intervention grounded in social cognitive theory and delivered both in home and via telephone to the caregivers of community-dwelling patients with dementia; the study will examine the intervention's impact on health-related quality of life in both caregivers and patients and on adverse patient outcomes. A Translational Support Core will provide resources to all projects for subject recruitment, assessment, data management, and statistical analysis. The common data set to examine translational dimensions and the efficiency of shared core support could not be achieved outside a program project approach nor could an examination of diverse elements of self-management strategies for improving treatment management and their impact on quality of life amongst persons with chronic conditions.

描述（由申请人提供）：该计划项目旨在通过检查针对遵守治疗方案的自我管理策略来改善生活质量，延迟或减慢慢性病的发展，从而提高护理的有效性，从而取得重叠的目标，以确定成功翻译的重叠目标。慢性疾病方案通常包括药物，体育锻炼，饮食改良和其他生活方式调整的结合。鉴于对规定的治疗的依从性的估计约为50％，因此在30-40％范围内有记录的治疗效果并不奇怪。与治疗方案管理问题有关的不良结果对患者，他们的护理人员和医疗保健系统都是昂贵的负担。本申请中提出的项目将检查针对个人，照顾者或医疗保健提供者的干预措施。这些项目将收集一个通用数据集，以促进干预措施的翻译，包括潜在的响应预测指标；是时候提供干预措施；干预主义者的培训时间；干预对参与者的可接受性；并且，干预的质量。核心评估将用于汇总数据。该计划项目建议中包括四个项目。项目1将检查利用自动过程的习惯训练干预措施，以提高药物依从性并确定有不遵守风险的患者。项目2将进行一项随机对照试验，以研究自我效能增强对生活方式改变疗法的依从性的能力；以及自我效能和/或乐观情绪在遵守饮食和运动变化中的作用。项目3将根据初级保健护士提供的单极抑郁症患者和合并症糖尿病或高血压的初级保健患者样本中的一致性治疗或高血压，评估基于初级保健护士提供的一致性治疗的单模性依从性干预的有效性；这项研究还将评估依从性抗抑郁治疗的改善是否与遵守口服药物的糖尿病或高血压有关。项目4将测试以社会认知理论为基础的量身定制的药物管理干预措施，并通过电话和电话交付给痴呆症患者的护理人员；该研究将检查干预措施对护理人员和患者以及不良患者结局的健康相关生活质量的影响。翻译支持核心将为所有项目提供资源，以进行主题招聘，评估，数据管理和统计分析。在计划项目方法之外无法实现转化维度和共享核心支持的效率的共同数据集，也无法检查自我管理策略的各种要素，以改善治疗管理及其对患有慢性状况的人的生活质量的影响。