目标设定电话提醒对缺血性脑卒中患者服药依从性的影响

目的探讨目标设定电话提醒对缺血性脑卒中患者服药依从性的影响。方法采用同期单盲随机对照研究,将缺血性脑卒中患者分为对照组和干预组。对照组采用常规健康教育法,干预组在接受常规健康教育的同时,在干预护士指导下设定服药目标及制定行动计划,并接受其3次电话提醒(出院后第1周及出院后第1个月、3个月)。在干预前、出院3个月、6个月时采用Morisky 4条服药依从性量表(MAS)分别测量两组患者的服药依从性。结果出院6个月干预组服药依从性高于对照组(P0.05);但干预前及出院3个月两组的服药依从性比较P0.05;两组患者出院3个月的服药依从性与干预前比较均得以提高,但出院3个月后至出院6个月的变化比较平稳,其中干预组的效果可延续到出院后6个月,且有上升趋势,但对照组呈下降趋势。结论目标设定电话提醒可提高缺血性脑卒中患者的服药依从性,是脑卒中患者出院延续护理的重要措施之一。

Effect of goal-setting telephone reminds on medication adherence for patients with ischemic stroke

Objective To evaluate the effect of goal-setting telephone reminds on medication adherence for patients with ischemic stroke.Methods An assessor-blinded,parallel-group,randomized trial was conducted.91 patients with ischemic stroke were randomly divided into control group and intervention group.Patients in control group was treated with routine health education.Patients in intervention group received the routine health education and 3 times of telephone reminders under the guidance of setting drug goals and action plans by intervention nurse (first weeks after discharge,after the discharge for first months and 3 months).Data for medication adherence were respectively collected and compared at baseline and at the 3rd,6th month after discharge from hospital using the Morisky medication adherence scale (MAS).Results At the 6th month after discharge,patients in the intervention group had significantly positive medication adherence compared with those in the control group (P＜0.05);but no significant difference was found between the two groups at baseline and at the 3rd month after discharge (P＞0.05).Compared with the baseline data,the medication compliance was improved in both groups at the 3rd month after discharge,but the change was relatively stable from the 3rd to 6th month after discharge.The effect of the intervention could be maintained to the 6th month after discharge with an upward trend,while the control group showed a downward trend.Conclusion The goal-setting telephone reminds is an important strategy of stroke transitional care,and leads to the improvement of medication compliance effectively for patients with ischemic stroke.