Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial
Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial
复制标题
使用螺旋桨健康哮喘平台进行人群健康管理的有效性：一项随机临床试验
DOI：
10.1016/j.jaip.2015.11.022
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发表时间：
2016-05-01
影响因子：
9.4
通讯作者：
Quade, Robert C.
中科院分区：
文献类型：
--
作者：
Merchant, Rajan K.;Inamdar, Rubina;Quade, Robert C.
背景技术背景：哮喘的远程医疗策略主要集中在控制药物的依从性上。短效β受体激动剂（SABA）的远程监测集中在使用模式上，可以更及时地采取行动以避免病情加重。评估这种方法的研究是lacked.OBJECTIVE：这个务实的对照研究的目的是衡量螺旋桨健康哮喘平台，以减少使用SABA和改善哮喘control.METHODS的真实世界的有效性：共495例患者参加了平行臂（1：1）为12个月的监测SABA的使用。干预组（IG）患者接受了螺旋桨健康系统的访问和反馈。常规护理（RC）患者配备了传感器，但没有收到反馈。医生能够监测他们的病人在IG的状态，并收到主动notifies.RESULTS：SABA的使用，每人每天平均数下降了0.41 IG和0.31 RC之间的第一周和其余的研究期间（P < .001组之间的差异）。同样，IG和RC的无SABA天数比例分别增加了21%和17%（组间差异P <0.01）。在整个研究人群中，两组之间的哮喘控制测试（ACT）评分无显著差异，但IG组与RC组相比，初始ACT评分未受控制的成人哮喘控制率的改善显著更大（研究期间控制率分别为63%和49%; P <0.05，比较2种改善）。与RC相比，使用Propeller Health系统监测SABA使用的研究组显著减少了SABA的使用，增加了无SABA的天数，并改善了ACT评分（后者在最初缺乏哮喘控制的成年人中）。(C)2016年美国过敏、哮喘和免疫学会
BACKGROUND: Telehealth strategies for asthma have focused primarily on adherence to controller medications.Telemonitoring of short-acting beta-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations. Studies assessing this approach are lacking.OBJECTIVE: This pragmatic controlled study was designed to measure real-world effectiveness of the Propeller Health Asthma Platform to reduce use of SABA and improve asthma control.METHODS: A total of 495 patients were enrolled in parallel arms (1: 1) for 12 months of monitoring SABA use. Intervention group (IG) patients received access to and feedback from the Propeller Health system. Routine care (RC) patients were outfitted with sensors but did not receive feedback. Physicians were able to monitor the status of their patients in the IG and receive proactive notifications.RESULTS: The daily mean number of SABA uses per person decreased by 0.41 for the IG and by 0.31 for RC between the first week and the remainder of the study period (P < .001 for the difference between groups). Similarly, the proportion of SABA-free days increased 21% for the IG and 17% for RC (P < .01 for the difference between groups). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in IG versus RC (63% controlled in the study period vs 49%, respectively; P < .05 comparing the 2 improvements).CONCLUSIONS: Compared with RC, the study arm monitoring SABA use with the Propeller Health system significantly decreased SABA use, increased SABA-free days, and improved ACT scores (the latter among adults initially lacking asthma control). (C) 2016 American Academy of Allergy, Asthma & Immunology