背景:随着全球老龄化社会的迅速发展,移动和健康数字市场已经大大扩展。无数的移动医疗应用程序(mmApps)在互联网市场如雨后春笋般涌现,旨在帮助慢性病患者实现用药安全。
目的:根据世界卫生组织提出的用药安全行动计划,我们旨在探讨mmApps在确保慢性病患者用药安全方面的有效性,包括mmApps是否可以提高报告药物不良事件(ADE)的意愿,提高患者的服药依从性,减少用药错误。我们希望通过系统评价和荟萃分析来验证我们的假设。
方法:荟萃分析严格按照PRISMA(系统评价和荟萃分析的首选报告项目)指南进行,并包括从7个数据库-PubMed中检索的文献,网络科学,Embase,CINAHL,中国国家知识基础设施,万方,还有SinoMed.发布时间限于2022年4月30日的数据库建立时间。根据纳入和排除标准筛选研究。提取的数据包括作者,出版多年,国家或地区,参与者的特征,干预组,和对照组,在其他人中。我们的质量评估遵循了Cochrane干预措施系统审查手册的指导方针,6.3版。采用RevMan5.2软件(CochraneCollaboration)进行统计分析,并进行敏感性分析以评估数据稳定性.通过使用不同的统计方法并从分析中排除大样本研究来计算稳定性程度。
结果:我们纳入了来自5个国家的8项研究(中国,美国,法国,加拿大,和西班牙),发布时间为2014年1月1日至2021年12月31日。参与者总数为1355,我们分析了纳入研究的特点,每个应用程序的功能,偏见的风险,和质量。结果显示,mmApps可以提高ADE报告意愿(相对风险[RR]2.59,95%CI1.26-5.30;P=.009),并显着提高服药依从性(RR1.17,95%CI1.04-1.31;P=.007),但它们对减少用药错误几乎没有影响(RR1.54,95%CI0.33-7.29;P=.58).
结论:我们分析了mmApps的以下三个优点,关于促进报告ADE的意愿:mmApps促进患者和医生之间的更多沟通,患者更加重视ADE报告,结果的处理是透明的。通过输送医疗解决方案,mmApps的使用提高了慢性病患者的用药依从性,提供教育支持,跟踪药物,允许远程咨询。最后,我们发现我们的用药错误结果与其他研究不同的3个潜在原因.
背景:PROSPERO国际系统评价前瞻性注册CRD42022322072;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=322072。
Along with the rapid growth of the global aging society, the mobile and health digital market has expanded greatly. Countless mobile medical apps (mmApps) have sprung up in the internet market, aiming to help patients with chronic diseases achieve medication safety.
Based on the medication safety action plans proposed by the World Health Organization, we aimed to explore the effectiveness of mmApps in ensuring the medication safety of patients with chronic diseases, including whether mmApps can improve the willingness to report adverse drug events (ADEs), improve patients\' medication adherence, and reduce medication errors. We hoped to verify our hypothesis through a systematic review and meta-analysis.
The meta-analysis was performed in strict accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included literature searched from 7 databases-PubMed, Web Of Science, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, and SinoMed. The publication time was limited to the time of database establishment to April 30, 2022. Studies were screened based on inclusion and exclusion criteria. The data extracted included authors, years of publication, countries or regions, participants\' characteristics, intervention groups, and control groups, among others. Our quality assessment followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions, Version 6.3. RevMan 5.2 software (Cochrane Collaboration) was used to analyze the statistical data, and a sensitivity analysis was performed to assess data stability. The degree of stability was calculated by using a different statistical method and excluding large-sample studies from the analysis.
We included 8 studies from 5 countries (China, the United States, France, Canada, and Spain) that were published from January 1, 2014, to December 31, 2021. The total number of participants was 1355, and we analyzed the characteristics of included studies, each app\'s features, the risk of bias, and quality. The results showed that mmApps could increase ADE reporting willingness (relative risk [RR] 2.59, 95% CI 1.26-5.30; P=.009) and significantly improve medication adherence (RR 1.17, 95% CI 1.04-1.31; P=.007), but they had little effect on reducing medication errors (RR 1.54, 95% CI 0.33-7.29; P=.58).
We analyzed the following three merits of mmApps, with regard to facilitating the willingness to report ADEs: mmApps facilitate more communication between patients and physicians, patients attach more importance to ADE reporting, and the processing of results is transparent. The use of mmApps improved medication adherence among patients with chronic diseases by conveying medical solutions, providing educational support, tracking medications, and allowing for remote consultations. Finally, we found 3 potential reasons for why our medication error results differed from those of other studies.
PROSPERO International Prospective Register of Systematic Reviews CRD42022322072; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322072.