Bussey-Smith Kristin L, Rossen Roger D
Baylor College of Medicine, Houston, Texas, USA.
Ann Allergy Asthma Immunol. 2007 Jun;98(6):507-16; quiz 516, 566. doi: 10.1016/S1081-1206(10)60727-2.
Educating patients with asthma about the pathophysiology and treatment of their disease is recommended. In recent years, several computer programs have been developed to provide this education. These programs take advantage of the population's increasing skill with computers and the growth of the Internet as a source of health care information.
To evaluate the effectiveness of published interactive computerized asthma patient education programs (CAPEPs) that have been subjected to randomized controlled trials (RCTs).
The PubMed, ERIC, CINAHL, Psychinfo, and Clinicaltrials.gov databases were searched (through October 3, 2005) using the following terms: asthma, patient, education, interactive, and computer.
RCTs in English that evaluated the effect of an interactive CAPEP on the following primary end points were included in the study: hospitalizations, acute care visits, rescue inhaler use, or lung function. Secondary end points included asthma knowledge and symptoms. Trials were screened by title and abstract before full text review. Two independent investigators used a standardized data extraction form to identify the articles chosen for full review.
Nine of 406 citations met inclusion criteria. Four CAPEPs were computer games, 7 only studied children, and 4 focused on urban populations. One study each showed that the intervention reduced the number of hospitalizations, acute care visits, or rescue inhaler use. Two studies reported lung function improvements. Four studies showed improvement in asthma knowledge, and 5 studies reported improvements in symptoms.
Although interactive CAPEPs may improve patient asthma knowledge and symptoms, their effect on objective clinical outcomes is less consistent.
建议对哮喘患者进行有关其疾病病理生理学和治疗方法的教育。近年来,已开发出多种计算机程序来提供此类教育。这些程序利用了人们日益提高的计算机技能以及互联网作为医疗保健信息来源的发展。
评估已进行随机对照试验(RCT)的已发表交互式计算机化哮喘患者教育项目(CAPEP)的有效性。
使用以下检索词检索了PubMed、ERIC、CINAHL、Psychinfo和Clinicaltrials.gov数据库(截至2005年10月3日):哮喘、患者、教育、交互式和计算机。
纳入本研究的英文RCT评估了交互式CAPEP对以下主要终点的影响:住院、急诊就诊、急救吸入器使用或肺功能。次要终点包括哮喘知识和症状。在全文审查之前,先通过标题和摘要对试验进行筛选。两名独立研究人员使用标准化数据提取表来确定选择进行全文审查的文章。
406条引文中有9条符合纳入标准。4个CAPEP是电脑游戏,7个仅研究儿童,4个关注城市人群。每项研究中分别有一项表明干预措施减少了住院次数、急诊就诊次数或急救吸入器的使用。两项研究报告肺功能有所改善。四项研究表明哮喘知识有所改善,五项研究报告症状有所改善。
虽然交互式CAPEP可能会改善患者的哮喘知识和症状,但其对客观临床结局的影响不太一致。