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远程医疗护理:患者和医生的可行性和认知:基于心力衰竭远程介入监测(TIM-HF)试验的接受度调查分析。

Telemedical care: feasibility and perception of the patients and physicians: a survey-based acceptance analysis of the Telemedical Interventional Monitoring in Heart Failure (TIM-HF) trial.

机构信息

Center for Cardiovascular Telemedicine, Charité-Universitätsmedizin Berlin, Germany.

出版信息

Eur J Prev Cardiol. 2013 Jun;20(2 Suppl):18-24. doi: 10.1177/2047487313487483e.

Abstract

BACKGROUND

The randomized Telemedical Interventional Monitoring in Heart Failure (TIM-HF) trial (NCT00543881) was performed during 2008 and 2010 to determine whether physician-led remote patient management (RPM) compared with usual care would result in reduced mortality and morbidity in stable out-patient heart failure (HF) patients. However, besides results of clinical benefit, the acceptance by patients and primary physicians is necessary for the implementation of RPM as part of the upcoming out-patient HF-care programs.

METHODS

Two months after finishing of the trial, a survey based analysis of the perception of telemedical care with patients (n=288) and primary physicians (n=102) was carried out. The survey included questions regarding self-management, usability and physician-patient communication.

RESULTS

The concept of RPM was perceived positively by patients and physicians. The devices were assessed as easy to use (98.6%, n=224) and robust (88.8%, n=202). Through trial participation and daily measurements most of the patients (85.5%, n=195) felt more confident in dealing with their disease than before. The perception of the nurses and physicians of the telemedical centers was professional (92.1%, n=210 and 89.9%, n=205) and committed (94.3%, n=215 and 91.7%, n=209). Also more than half of the patients noticed an improvement in the contact with their primary physician (52.6%, n=120); and for 46.1% (n=105) the contact has not been changed.

CONCLUSIONS

RPM will be a medical care concept for recently hospitalized HF- patients in the near future but the optimal telemedical setting of RPM and the duration of this intervention have to be defined in further clinical trials.

摘要

背景

随机远程医疗心力衰竭干预监测(TIM-HF)试验(NCT00543881)于 2008 年至 2010 年进行,旨在确定与常规治疗相比,医生主导的远程患者管理(RPM)是否会降低稳定的门诊心力衰竭(HF)患者的死亡率和发病率。然而,除了临床获益的结果外,患者和初级医生的接受程度对于 RPM 的实施是必要的,因为 RPM 将作为即将推出的门诊 HF 护理计划的一部分。

方法

试验结束后两个月,对患者(n=288)和初级医生(n=102)的远程医疗护理感知进行了基于调查的分析。该调查包括有关自我管理、可用性和医患沟通的问题。

结果

RPM 的概念得到了患者和医生的积极认可。这些设备被评估为易于使用(98.6%,n=224)和坚固耐用(88.8%,n=202)。通过试验参与和日常测量,大多数患者(85.5%,n=195)在处理疾病方面比以前更有信心。远程医疗中心的护士和医生的看法是专业的(92.1%,n=210 和 89.9%,n=205)和投入的(94.3%,n=215 和 91.7%,n=209)。也有超过一半的患者注意到与他们的初级医生的接触有所改善(52.6%,n=120);而对于 46.1%(n=105)的患者,接触没有改变。

结论

在不久的将来,RPM 将成为最近住院的 HF 患者的医疗保健概念,但必须在进一步的临床试验中定义 RPM 的最佳远程医疗设置和干预持续时间。

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