Mondorf W, Siegmund B, Mahnel R, Richter H, Westfeld M, Galler A, Pollmann H
Haemostas--Praxis und Labor zur Diagnostik von Blutgerinnungsstörungen, Frankfurt, Germany.
Haemophilia. 2009 Mar;15(2):464-72. doi: 10.1111/j.1365-2516.2008.01941.x. Epub 2009 Feb 16.
On-demand or prophylactic home-treatment is currently the treatment of choice for haemophilia patients. To allow physicians to monitor the amount of factor concentrates administered, the patients document each factor injection in a paper-diary. Nevertheless, because of the fact that most patients visit their physicians only two to four times a year, there could be considerable delay in detecting medication problems. The aim of this pilot study was to assess whether an electronic documentation tool could successfully replace traditional paper-diaries for haemophilia A patients and enable the physician to have a timely overview of the patient's treatment. An electronic, hand-held documentation tool, Haemoassist, was developed. In this study, patients using prophylaxis and on-demand therapies documented their factor consumption both electronically and on paper-diaries. Documentations were compared and descriptively evaluated. Patients also completed a survey to evaluate the feasibility and gather their opinions on the Haemoassist system. Ten patients from two haemophilia treatment centres in Germany submitted a total of 548 records via hand-held device during the observation period, from March 2006 to February 2007. Comparison of electronic and paper-based records showed differing responses among patients with some patients entering more electronic and some others more paper-based documentations. In the questionnaires on feasibility and usefulness of Haemoassist, three patients preferred the electronic tool, two patients wanted to continue using paper-based diaries, and one had no preference. The study shows that an electronic documentation system is feasible for haemophilia patients and provides the physician with the opportunity to more closely monitor patients. However, not all patients seem to be qualified for using an electronic tool, and the tool has to run reliably without major errors for ensuring reliability and acceptability. In the future, Haemoassist might support quality assurance in haemophilia treatment and improve guidance in the home-care setting.
按需或预防性家庭治疗目前是血友病患者的首选治疗方式。为便于医生监测凝血因子浓缩剂的使用量,患者需在纸质日记中记录每次凝血因子注射情况。然而,由于大多数患者每年仅看医生两到四次,在发现用药问题方面可能会有相当长的延迟。这项试点研究的目的是评估电子记录工具能否成功取代血友病A患者的传统纸质日记,并使医生能够及时全面了解患者的治疗情况。研发了一种电子手持记录工具Haemoassist。在本研究中,采用预防性和按需治疗的患者通过电子方式和纸质日记记录其凝血因子使用情况。对记录进行比较并进行描述性评估。患者还完成了一项调查,以评估Haemoassist系统的可行性并收集他们的意见。在2006年3月至2007年2月的观察期内,来自德国两个血友病治疗中心的10名患者通过手持设备共提交了548条记录。电子记录与纸质记录的比较显示,患者之间的反应存在差异,一些患者录入的电子记录更多,而另一些患者录入的纸质记录更多。在关于Haemoassist可行性和实用性的问卷中,三名患者更喜欢电子工具,两名患者希望继续使用纸质日记,一名患者没有偏好。该研究表明,电子记录系统对血友病患者是可行的,并为医生提供了更密切监测患者的机会。然而,并非所有患者似乎都适合使用电子工具,并且该工具必须可靠运行且无重大错误,以确保可靠性和可接受性。未来,Haemoassist可能会支持血友病治疗的质量保证,并改善家庭护理环境中的指导。