A Randomized Controlled Trial of a Mobile Health Intervention to Promote Self-Management After Lung Transplantation.
A Randomized Controlled Trial of a Mobile Health Intervention to Promote Self-Management After Lung Transplantation.
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DOI：
10.1111/ajt.13701
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Dew MA
中科院分区：
文献类型：
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作者：
DeVito Dabbs A;Song MK;Myers BA;Li R;Hawkins RP;Pilewski JM;Bermudez CA;Aubrecht J;Begey A;Connolly M;Alrawashdeh M;Dew MA
鼓励肺移植受者进行自我管理行为，包括：1）监测健康指标，2）坚持他们的方案，3）向移植协调员报告异常健康指标，但表现不佳。当即将出院时，这项两组试验随机分配了201名接受者使用移动健康干预（n=99）或常规护理（n=102），以比较移植后第一年内促进自我管理行为（主要结局）和自我护理机构，再住院和死亡率（次要结局）的有效性。移动健康干预组进行自我监测（OR=5.11，95% CI 2.95-8.87，p<.001），遵守医疗方案（OR=1.64，95% CI 1.01-2.66，p=0.046），并报告异常健康指标（OR= 8.9，95% CI 3.60-21.99，p<.001）比常规护理组更频繁。然而，两组在再住院（OR= 0.78，95% CI 0.36-1.66，p= 0.51）或死亡率（HR= 1.71，0.68-4.28，p= 0.25）方面无差异。移动健康干预对自我管理行为的积极影响表明，干预措施有希望，值得进一步测试。试验注册ClinicalTrials.Gov NCT 00818025
Lung transplant recipients are encouraged to perform self-management behaviors including: 1) monitoring health indicators, 2) adhering to their regimen, and 3) reporting abnormal health indicators to the transplant coordinator, yet performance is suboptimal. When hospital discharge was imminent, this two-group trial randomized 201 recipients to use either the-mHealth intervention (n=99), or usual care (n=102), to compare efficacy for promoting self-management behaviors (primary outcomes) and self-care agency, re-hospitalization and mortality (secondary outcomes) at home during the first year after transplant. The mHealth intervention group performed self-monitoring (OR=5.11, 95% CI 2.95–8.87, p<.001), adhered to medical regimen (OR=1.64, 95% CI 1.01–2.66, p=0.046) and reported abnormal health indicators (OR= 8.9, 95% CI 3.60–21.99, p<.001) more frequently than the usual care group. However, the two groups did not differ in re-hospitalization (OR= 0.78, 95% CI 0.36-1.66, p=.51) or mortality (HR= 1.71, 0.68-4.28, p=.25). The positive impact of the mHealth intervention on self-management behaviors suggests that the intervention holds promise and warrants further testing. TRIAL REGISTRATION ClinicalTrials.Gov NCT00818025