Bilbao Primary Health Care Region, Osakidetza - Basque Health Service, Bizkaia, Spain.
BMC Health Serv Res. 2011 Mar 8;11:56. doi: 10.1186/1472-6963-11-56.
Telemonitoring technology offers one of the most promising alternatives for the provision of health care services at the patient's home. The primary aim of this study is to evaluate the impact of a primary care-based telemonitoring intervention on the frequency of hospital admissions.
METHODS/DESIGN: A primary care-based randomised controlled trial will be carried out to assess the impact of a telemonitoring intervention aimed at home care patients with heart failure (HF) and/or chronic lung disease (CLD). The results will be compared with those obtained with standard health care practice. The duration of the study will be of one year. Sixty patients will be recruited for the study. In-home patients, diagnosed with HF and/or CLD, aged 14 or above and with two or more hospital admissions in the previous year will be eligible. For the intervention group, telemonitoring will consist of daily patient self-measurements of respiratory-rate, heart-rate, blood pressure, oxygen saturation, weight and body temperature. Additionally, the patients will complete a qualitative symptom questionnaire daily using the telemonitoring system. Routine telephone contacts will be conducted every fortnight and additional telephone contacts will be carried out if the data received at the primary care centre are out of the established limits. The control group will receive usual care. The primary outcome measure is the number of hospital admissions due to any cause that occurred in a period of 12 months post-randomisation. The secondary outcome measures are: duration of hospital stay, hospital admissions due to HF or CLD, mortality rate, use of health care resources, quality of life, cost-effectiveness, compliance and patient and health care professional satisfaction with the new technology.
The results of this study will shed some light on the effects of telemonitoring for the follow-up and management of chronic patients from a primary care setting. The study may contribute to enhance the understanding of alternative modes of health care provision for medically unstable elderly patients, who bear a high degree of physical and functional deterioration.
远程监控技术为在患者家中提供医疗服务提供了最有前途的选择之一。本研究的主要目的是评估基于初级保健的远程监控干预对住院频率的影响。
方法/设计：将开展一项基于初级保健的随机对照试验，以评估针对心力衰竭（HF）和/或慢性肺部疾病（CLD）的家庭护理患者的远程监控干预的影响。结果将与标准保健实践获得的结果进行比较。研究的持续时间为一年。将招募 60 名符合条件的患者参加该研究。符合条件的患者为在家中接受治疗、被诊断为 HF 和/或 CLD、年龄在 14 岁及以上且在过去一年中有两次或两次以上住院经历的患者。对于干预组，远程监控将包括患者每天自行测量呼吸频率、心率、血压、血氧饱和度、体重和体温。此外，患者将每天使用远程监控系统完成一份定性症状问卷。每两周进行一次常规电话联系，如果初级保健中心收到的数据超出既定范围，则进行额外的电话联系。对照组将接受常规护理。主要结局指标是随机分组后 12 个月内因任何原因导致的住院人数。次要结局指标包括：住院时间、因 HF 或 CLD 导致的住院、死亡率、卫生保健资源的使用、生活质量、成本效益、依从性以及患者和卫生保健专业人员对新技术的满意度。
本研究的结果将阐明远程监控对从初级保健角度对慢性患者进行随访和管理的影响。该研究可能有助于增进对为身体和功能恶化程度较高的不稳定老年患者提供替代医疗服务模式的理解。
