Effectiveness of Telemonitoring in Patients with Chronic Obstructive Pulmonary Disease in Taiwan-A Randomized Controlled Trial.
Effectiveness of Telemonitoring in Patients with Chronic Obstructive Pulmonary Disease in Taiwan-A Randomized Controlled Trial.
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DOI：
10.1038/srep23797
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发表时间：
2016-03-31
影响因子：
4.6
通讯作者：
HINT Study Group
中科院分区：
文献类型：
--
作者：
Ho TW;Huang CT;Chiu HC;Ruan SY;Tsai YJ;Yu CJ;Lai F;HINT Study Group
慢性阻塞性肺疾病（COPD）是世界范围内导致死亡的主要原因，并造成巨大的经济和社会负担。远程监护已被提出作为解决这一日益严重的问题的一种方法，但其对患者预后的影响尚不明确。本随机对照试验旨在探讨远程监护在改善COPD患者预后方面的有效性。106名受试者被随机分为远程监护组（n = 53）和常规护理组（n = 53）。在出院后的两个月里，远程监护组患者必须每天使用电子日记报告他们的症状。主要结局指标是出院后6个月内首次因COPD加重再次入院的时间。随访期间，远程监护组患者因COPD加重而再次入院的时间明显高于常规护理组（p = 0.026）。远程监护还与全因再入院次数减少有关（0.23 vs. 0.23）。0.68 /病人;P = 0.002)和急诊室就诊(P = 0.36 vs。0.91 /病人;p = 0.006)。总之，在一个国土面积小、医疗服务可及性高的国家，远程监测干预与因病情加重而入院的COPD患者的预后改善有关。研究结果令人鼓舞，并进一步支持将远程监测作为COPD治疗的一部分。
Chronic obstructive pulmonary disease (COPD) is the leading cause of death worldwide, and poses a substantial economic and social burden. Telemonitoring has been proposed as a solution to this growing problem, but its impact on patient outcome is equivocal. This randomized controlled trial aimed to investigate effectiveness of telemonitoring in improving COPD patient outcome. In total, 106 subjects were randomly assigned to the telemonitoring (n = 53) or usual care (n = 53) group. During the two months following discharge, telemonitoring group patients had to report their symptoms daily using an electronic diary. The primary outcome measure was time to first re-admission for COPD exacerbation within six months of discharge. During the follow-up period, time to first re-admission for COPD exacerbation was significantly increased in the telemonitoring group than in the usual care group (p = 0.026). Telemonitoring was also associated with a reduced number of all-cause re-admissions (0.23 vs. 0.68/patient; p = 0.002) and emergency room visits (0.36 vs. 0.91/patient; p = 0.006). In conclusion, telemonitoring intervention was associated with improved outcomes among COPD patients admitted for exacerbation in a country characterized by a small territory and high accessibility to medical services. The findings are encouraging and add further support to implementation of telemonitoring as part of COPD care.