Bernocchi Palmira, Baratti Doriana, Zanelli Emanuela, Rocchi Silvana, Salvetti Massimo, Paini Anna, Scalvini Simonetta
Telemedicina Service, Fondazione Salvatore Maugeri, IRCCS, Institute of Lumezzane, Brescia, Italy.
Eur J Cardiovasc Prev Rehabil. 2011 Jun;18(3):481-7. doi: 10.1177/1741826710389364. Epub 2011 Feb 18.
Technology and information systems enabling transmission of patients' data and ability to provide and exchange professional support remotely to the general practitioners can improve quality and continuity of care.
We set up a programme of primary prevention in 27 patients at risk for cardiovascular diseases by using Telemedicine Service for 6 months.
Telemedicine Service enlisted the involvement of physicians and nurse-tutors. The following cardiovascular activity markers were assessed: (i) cardiovascular risk cards (Framingham Study and Progetto CUORE); (ii) blood pressure; (iii) physical activity (three sessions of bicycle exercise training and calisthenic exercises a week); and (iv) questionnaires on stress and quality of life.
Both cardiovascular risk cards showed a statistically significant reduction of the score (p < 0.05). Systolic and diastolic blood pressures showed a statistically significant reduction (128 ± 10 mmHg vs. 121 ± 9 mmHg, p = 0.04; 80 ± 8 mmHg vs. 73 ± 7 mmHg, p = 0.001). There was a noticeable increase in patient compliance for reporting blood pressure data. 89% of patients complied with the physical activity programme. Effort test significantly increased from 11.4 ± 3.5 to 12.7 ± 3.4 min (p = 0.02). There was a significant improvement in physical health (p = 0.04) and 85% of patients were satisfied with the service.
A home multidisciplinary programme for primary cardiovascular disease prevention is simple, efficacious, and very well accepted by the patients with the majority of patients showing reduction in cardiovascular risk scores.
能够传输患者数据以及具备远程为全科医生提供和交流专业支持能力的技术与信息系统，可提高医疗质量和连续性。
我们通过使用远程医疗服务，对27名有心血管疾病风险的患者开展了为期6个月的一级预防项目。
远程医疗服务促使医生和护士导师参与其中。评估了以下心血管活动指标：（i）心血管风险卡片（弗明汉姆研究和CUORE项目）；（ii）血压；（iii）身体活动（每周三次自行车运动训练和健身操练习）；以及（iv）关于压力和生活质量的问卷。
两张心血管风险卡片的得分均有统计学显著降低（p < 0.05）。收缩压和舒张压均有统计学显著降低（128 ± 10 mmHg对121 ± 9 mmHg，p = 0.04；80 ± 8 mmHg对73 ± 7 mmHg，p = 0.001）。患者报告血压数据的依从性显著提高。89%的患者遵守身体活动计划。运动耐力测试从11.4 ± 3.5分钟显著增加至12.7 ± 3.4分钟（p = 0.02）。身体健康状况有显著改善（p = 0.04），85%的患者对该服务满意。
一项针对心血管疾病一级预防的家庭多学科项目简单、有效，且深受患者欢迎，大多数患者的心血管风险评分降低。
