Telehealth services to improve nonadherence: A placebo-controlled study.
Telehealth services to improve nonadherence: A placebo-controlled study.
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改善不依从性的远程医疗服务：一项安慰剂对照研究。
DOI：
10.1089/tmj.2006.12.289
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Leeds,William
中科院分区：
文献类型：
--
作者：
Smith,CarolE;Dauz,EmilyR;Clements,Faye;Puno,FlorenceN;Cook,David;Doolittle,Gary;Leeds,William
本研究的目的是测试远程医疗干预是否可以提高睡眠呼吸暂停患者对持续气道正压通气（CPAP）的依从性。这些患者在最初的3个月治疗中没有依从性，即使在接受了最初的标准治疗后，然后接受了补充的每晚依从CPAP的录音/录像患者教育。材料和方法包括实验和安慰剂干预的随机测试。护士在12周的时间内通过远程保健向两组家庭提供干预措施。安慰剂干预被用来控制霍桑效应，时间和注意力的影响和新奇的远程医疗在家里。结果远程医疗干预后，实验组1（n= 10）夜间坚持CPAP治疗的患者明显多于安慰剂组2（n= 9）（χ2= 4.55，p = 0.033）。第1组患者对干预措施的满意度更高。然而，这两个群体都对远程保健服务给予了积极评价。每次20分钟远程医疗访问的平均成本为30美元，而每位患者的远程医疗干预总成本为420美元。这些费用包括远程医疗设备、初始安装、长途电话费、护士工资和干预材料。结论是，远程保健干预措施是一种潜在的具有成本效益的服务，以增加遵守规定的医疗。建议在大样本和其他临床组中进行重复研究。
The objective of this study was to test whether a telehealth intervention could improve the compliance with continuous positive airway pressure (CPAP) by patients with sleep apnea. These patients had been nonadherent for the initial 3 months of therapy even after receiving the initial standard and then supplemental audiotaped/videotaped patient education for adhering to CPAP nightly. The materials and methods included a randomized testing of experimental and placebo interventions. Interventions were delivered by nurses to two groups in their homes by telehealth over a 12-week period. The placebo intervention was used to control for Hawthorne effect, time and attention influences and the novelty of having telehealth in the home. Results following the telehealth interventions were that significantly more patients in the experimental group 1 (n= 10) than the placebo group 2 (n= 9) were adhering nightly to CPAP (χ2= 4.55,p= 0.033). Group 1 patients reported greater satisfaction with their intervention. However, both groups rated telehealth delivery positively. The mean cost of each 20-minute telehealth visit was $30 while the total cost of the telehealth intervention for each patient was $420. These costs included telehealth equipment, initial installation, longdistance telephone charges, nurse salary, and intervention materials. Conclusions are that telehealth interventions are a potentially cost-effective service for increasing adherence to prescribed medical treatments. Replication studies with large samples and in other clinical groups are recommended.