Mobile phone-based telemonitoring for heart failure management: a randomized controlled trial.
Mobile phone-based telemonitoring for heart failure management: a randomized controlled trial.
复制标题
DOI：
10.2196/jmir.1909
复制
发表时间：
2012-02-16
影响因子：
7.4
通讯作者：
Ross HJ
中科院分区：
文献类型：
--
作者：
Seto E;Leonard KJ;Cafazzo JA;Barnsley J;Masino C;Ross HJ
以前的远程监测心力衰竭管理试验报告了不一致的结果，主要是由于不同的干预和研究设计。移动的电话正变得普遍和经济，但是基于移动的电话的远程监护系统的可行性和有效性尚未确定。本试验的目的是研究基于移动的电话的远程监护系统对心力衰竭管理和结局的影响。从心功能诊所招募了100名患者，并随机分为远程监测组和对照组。远程监护组（N = 50）每天测量体重和血压读数，每周进行单导联心电图检查，并在6个月内通过移动的电话回答日常症状问题。读数被自动无线传输到移动的手机，然后传输到数据服务器。将说明发送到患者的移动的电话，并根据需要向心脏病专家的移动的电话发出警报。94名患者完成并返回了基线问卷，84名患者返回了研究后问卷。大约70%的远程监护患者完成了至少80%的日常读数。与对照组相比，远程监护组的生活质量从基线到研究后的变化（采用明尼苏达心力衰竭生活问卷测量）显著更大（P = .05）。组间分析还发现远程监护组的研究后自我护理维护（用心力衰竭自我护理指数测量）更高（P = .03）。从基线到研究后，两组的脑钠肽（BNP）水平、自我护理管理和左心室射血分数（LVEF）均显著改善，但未显示组间差异。然而，使用63名参加心功能诊所超过6个月的患者的数据进行的亚组组内分析显示，远程监测组的BNP从基线到研究后有显著改善（降低150 pg/mL，P = .02），LVEF（增加7.4%，P = 0.005）和自我护理维护（增加7分，P = 0.05）和管理（增加14分，P = 0.03），而对照组没有。远程监护组和对照组在住院率、死亡率或急诊就诊率方面没有发现差异，但该试验在检测这些指标的差异方面能力不足。我们的研究结果提供了证据，通过改善自我护理和临床管理，从一个移动的电话为基础的远程监护系统，提高生活质量。使用基于移动的电话的系统具有很高的依从性，并且对于患者是可行的，包括老年人和没有移动的电话使用经验的患者。ClinicalTrials.gov www.example.com
Previous trials of telemonitoring for heart failure management have reported inconsistent results, largely due to diverse intervention and study designs. Mobile phones are becoming ubiquitous and economical, but the feasibility and efficacy of a mobile phone-based telemonitoring system have not been determined. The objective of this trial was to investigate the effects of a mobile phone-based telemonitoring system on heart failure management and outcomes. One hundred patients were recruited from a heart function clinic and randomized into telemonitoring and control groups. The telemonitoring group (N = 50) took daily weight and blood pressure readings and weekly single-lead ECGs, and answered daily symptom questions on a mobile phone over 6 months. Readings were automatically transmitted wirelessly to the mobile phone and then to data servers. Instructions were sent to the patients’ mobile phones and alerts to a cardiologist’s mobile phone as required. Baseline questionnaires were completed and returned by 94 patients, and 84 patients returned post-study questionnaires. About 70% of telemonitoring patients completed at least 80% of their possible daily readings. The change in quality of life from baseline to post-study, as measured with the Minnesota Living with Heart Failure Questionnaire, was significantly greater for the telemonitoring group compared to the control group (P = .05). A between-group analysis also found greater post-study self-care maintenance (measured with the Self-Care of Heart Failure Index) for the telemonitoring group (P = .03). Brain natriuretic peptide (BNP) levels, self-care management, and left ventricular ejection fraction (LVEF) improved significantly for both groups from baseline to post-study, but did not show a between-group difference. However, a subgroup within-group analysis using the data from the 63 patients who had attended the heart function clinic for more than 6 months revealed the telemonitoring group had significant improvements from baseline to post-study in BNP (decreased by 150 pg/mL, P = .02), LVEF (increased by 7.4%, P = .005) and self-care maintenance (increased by 7 points, P = .05) and management (increased by 14 points, P = .03), while the control group did not. No differences were found between the telemonitoring and control groups in terms of hospitalization, mortality, or emergency department visits, but the trial was underpowered to detect differences in these metrics. Our findings provide evidence of improved quality of life through improved self-care and clinical management from a mobile phone-based telemonitoring system. The use of the mobile phone-based system had high adherence and was feasible for patients, including the elderly and those with no experience with mobile phones. ClinicalTrials.gov NCT00778986
登录
查看更多内容
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
7.4
作者：
Scherr D;Kastner P;Kollmann A;Hallas A;Auer J;Krappinger H;Schuchlenz H;Stark G;Grander W;Jakl G;Schreier G;Fruhwald FM;MOBITEL Investigators
通讯作者：
MOBITEL Investigators
影响因子：
2
作者：
Riegel, Barbara;Lee, Christopher S.;Carlson, Beverly
通讯作者：
Carlson, Beverly
DOI：
10.1056/nejmoa1010029
发表时间：
2010-12-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chaudhry SI;Mattera JA;Curtis JP;Spertus JA;Herrin J;Lin Z;Phillips CO;Hodshon BV;Cooper LS;Krumholz HM
通讯作者：
Krumholz HM
影响因子：
2.5
作者：
Riegel, B;Moser, DK;Albert, N
通讯作者：
Albert, N