Paré Guy, Moqadem Khalil, Pineau Gilles, St-Hilaire Carole
HEC Montreal, Montreal, Canada.
J Med Internet Res. 2010 Jun 16;12(2):e21. doi: 10.2196/jmir.1357.
Home telemonitoring figures among the various solutions that could help attenuate some of the problems associated with aging populations, rates of chronic illness, and shortages of health professionals.
The primary aim of this study was to further our understanding of the clinical effects associated with home telemonitoring programs in the context of chronic diseases.
We conducted a systematic review which covered studies published between January 1966 and December 2008. MEDLINE, The Cochrane Library, and the INAHTA (International Network of Agencies for Health Technology Assessment) database were consulted. Our inclusion criteria consisted of: (1) English language publications in peer-reviewed journals or conference proceedings and (2) studies involving patients with diabetes, asthma, heart failure, or hypertension, and presenting results on the clinical effects of home telemonitoring.
In all, 62 empirical studies were analyzed. The results from studies involving patients with diabetes indicated a trend toward patients with home telemonitoring achieving better glycemic control. In most trials in which patients with asthma were enrolled, results showed significant improvements in patients' peak expiratory flows, significant reductions in the symptoms associated with this illness, and improvements in perceived quality of life. Virtually all studies involving patients with hypertension demonstrated the ability of home telemonitoring to reduce systolic and/or diastolic blood pressure. Lastly, due to the equivocal nature of current findings of home telemonitoring involving patients with heart failure, larger trials are still needed to confirm the clinical effects of this technology for these patients.
Although home telemonitoring appears to be a promising approach to patient management, designers of future studies should consider ways to make this technology more effective as well as controlling possible mediating variables.
家庭远程监测是多种解决方案之一，有助于缓解与老龄化人口、慢性病发病率和卫生专业人员短缺相关的一些问题。
本研究的主要目的是进一步了解慢性病背景下家庭远程监测项目的临床效果。
我们进行了一项系统综述，涵盖1966年1月至2008年12月发表的研究。查阅了MEDLINE、Cochrane图书馆和INAHTA（国际卫生技术评估机构网络）数据库。我们的纳入标准包括：（1）同行评审期刊或会议论文集中的英文出版物；（2）涉及糖尿病、哮喘、心力衰竭或高血压患者的研究，并呈现家庭远程监测临床效果的结果。
总共分析了62项实证研究。涉及糖尿病患者的研究结果表明，接受家庭远程监测的患者有实现更好血糖控制的趋势。在大多数纳入哮喘患者的试验中，结果显示患者的呼气峰值流量有显著改善，与该疾病相关的症状显著减少，生活质量感知有所提高。几乎所有涉及高血压患者的研究都表明家庭远程监测能够降低收缩压和/或舒张压。最后，由于目前关于心力衰竭患者家庭远程监测的研究结果不明确，仍需要更大规模的试验来证实该技术对这些患者的临床效果。
尽管家庭远程监测似乎是一种有前景的患者管理方法，但未来研究的设计者应考虑如何使该技术更有效，并控制可能的中介变量。
