Chronic disease
Conditions
Interventions
Intervention group:Leveraging a predictive model to identify high-risk patients with poor adherence, precision interventions in home pharmacy services are implemented based on the ITHBC behavior chang
Control group:Receives only conventional home pharmacy services (such as distributing educational materials and providing routine reminders) without targeted interventions based on the predictive mode
Observational group:None
Sponsors
Beijing Tiantan Hospital, Capital Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: 1.Part One: Elderly patients with chronic diseases aged 60 or above. 2.Part Two: (1) Patients who have been clearly diagnosed with one of the chronic diseases: hypertension, type 2 diabetes, coronary heart disease or stroke. (2) Currently taking two or more chronic disease medications for treatment; (3) Older than 60 years old; (4) Be aware of the research purpose and sign the informed consent form; (5) Be capable of independent communication, have a clear consciousness, no cognitive impairment, and be able to accept the assessment of medication compliance and the intervention of pharmacists; Be able to consistently record medication information and monitoring indicators, agree to the researcher's home visit to provide home pharmaceutical care and cooperate with at least six months of follow-up. (6) There is a chronic disease monitoring result for the past month and it is agreed to conduct monitoring during the 6-month follow-up period.
Exclusion criteria
Exclusion criteria: Part One: None Part Two: Patients with malignant tumors, mental disorders, hearing impairments, those unable to communicate independently, those with limited mobility, and those unable to cooperate in completing the research.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Medication adherence score; | — |
Secondary
| Measure | Time frame |
|---|---|
| Achievement of chronic disease control targets and laboratory test results including blood pressure, lipid profile, glucose, liver and renal function within the past 3 months;Patient satisfaction score;Patient quality of life score;Direct medical costs for chronic disease and complication management;Accuracy rate;Recall rate;F1 points;The area under the ROC curve; | — |
Countries
China
Contacts
Public ContactWu Mingfen
Beijing Tiantan Hospital, Capital Medical University
Outcome results
None listed