Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands.
J Clin Nurs. 2011 Nov;20(21-22):2997-3010. doi: 10.1111/j.1365-2702.2011.03743.x. Epub 2011 Jun 27.
We aimed to investigate whether e-health is equal to or better than usual face-to-face care with regard to outcomes on health, quality of life, patient satisfaction and costs. Therefore, we systematically reviewed the literature on e-health in chronically ill patients compared with or as an addition to usual care.
Interactive websites on internet are increasingly used to inform and treat patients. This type of contact between patients and health care providers, which is called e-health, is easily accessible and particularly interesting for chronically ill patients.
A systematic review.
We searched the databases PubMed, CINAHL, the Cochrane Database of systematic reviews, DARE and CENTRAL for articles published between January 2000-July 2009.
The search strategy yielded in total 695 possibly relevant references, which resulted in 12 RCTs after application of the in- and exclusion criteria. Most of the studies were well designed according to the Cochrane criteria for RCTs. The studies are divided into e-health vs. usual care and e-health as addition to usual care. e-Health consisted of monitoring, treatment instructions, self-management training and general information and communication between patient and caregiver. Most of the studies showed small to moderate positive effects on health outcomes. Cost-effectiveness, quality of life and patient satisfaction were rarely investigated in the included studies.
e-Health interventions for chronically ill patients, offered instead of usual care or in addition to usual care, lead to small to moderate positive effects on primary health outcomes. However, the evidence was not fully convincing, because of the limited number of studies available and the methodological limitations. Further research is needed to confirm the cost-effectiveness of e-health interventions for patients with chronic diseases.
e-Health is a promising tool for treatment and self-management training of chronically ill patients.
我们旨在调查电子健康是否在健康结果、生活质量、患者满意度和成本方面与常规面对面护理相当或更优。因此，我们系统地综述了慢性疾病患者接受电子健康干预与常规护理相比或作为常规护理的补充的相关文献。
互联网上的互动网站越来越多地被用于为患者提供信息和治疗。这种患者与医疗保健提供者之间的联系，即电子健康，易于获取，对慢性疾病患者尤其有吸引力。
系统综述。
我们在 PubMed、CINAHL、Cochrane 系统评价数据库、DARE 和 CENTRAL 数据库中搜索了 2000 年 1 月至 2009 年 7 月期间发表的文章。
搜索策略共产生了 695 篇可能相关的参考文献，应用纳入和排除标准后，最终纳入了 12 项 RCT。根据 Cochrane RCT 标准，大多数研究设计良好。这些研究分为电子健康与常规护理相比和电子健康作为常规护理的补充。电子健康包括监测、治疗指导、自我管理培训和一般信息以及患者与护理人员之间的沟通。大多数研究显示对健康结果有小到中度的积极影响。纳入的研究很少调查成本效益、生活质量和患者满意度。
为慢性疾病患者提供的电子健康干预措施，无论是替代常规护理还是作为常规护理的补充，都能对主要健康结果产生小到中度的积极影响。然而，由于可用研究数量有限和方法学上的限制，证据并不完全令人信服。需要进一步的研究来证实电子健康干预对慢性疾病患者的成本效益。
电子健康是治疗和慢性疾病患者自我管理培训的有前途的工具。
