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基于移动健康技术的心力衰竭干预措施的系统评价

A Systematic Review of mHealth-Based Heart Failure Interventions.

作者信息

Cajita Maan Isabella, Gleason Kelly T, Han Hae-Ra

机构信息

Maan Isabella Cajita, BSN, RN-BC PhD Student, School of Nursing, Johns Hopkins University, Baltimore, Maryland.Kelly T. Gleason, BSN, RN PhD Student, School of Nursing, Johns Hopkins University, Baltimore, Maryland.Hae-Ra Han, PhD, RN, FAAN Associate Professor, School of Nursing, Johns Hopkins University, Baltimore, Maryland.

出版信息

J Cardiovasc Nurs. 2016 May-Jun;31(3):E10-22. doi: 10.1097/JCN.0000000000000305.

Abstract

BACKGROUND

The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors.

PURPOSE

This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes.

METHODS

PubMed, CINAHL Plus, EMBASE, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps.

CONCLUSIONS

Ten articles, representing 9 studies, were included in this review. The majority of the studies utilized mobile health technology as part of an HF monitoring system, which typically included a blood pressure-measuring device, weighing scale, and an electrocardiogram recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, New York Heart Association functional class, left ventricular ejection fraction, quality of life, and self-care were inconsistent at best.

IMPLICATIONS

Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (eg, inadequate sample size, quasi-experimental design, use of older mobile phone models, etc) should be taken into account when designing future studies.

摘要

背景

手机及类似移动设备的普及使其成为提供干预措施的理想媒介。对于心力衰竭(HF)干预措施而言尤其如此,基于移动健康(mHealth)的HF干预措施正在迅速取代其基于电话的前身。

目的

本系统评价考察了基于mHealth的HF管理干预措施对HF结局的影响。该系统评价的具体目的是:(1)描述当前基于mHealth的HF干预措施;(2)讨论这些干预措施对HF结局的影响。

方法

系统检索PubMed、CINAHL Plus、EMBASE、PsycINFO和Scopus,查找使用心力衰竭、移动健康、mHealth、远程医疗、短信、文本消息、短消息服务、移动应用程序和移动应用等术语,对HF患者进行mHealth干预测试的随机对照试验或准实验研究。

结论

本评价纳入了10篇文章,代表9项研究。大多数研究将移动健康技术用作HF监测系统的一部分,该系统通常包括血压测量设备、体重秤和心电图记录仪。mHealth干预措施对全因死亡率、心血管死亡率、HF相关住院率、住院时间、纽约心脏协会心功能分级、左心室射血分数、生活质量和自我护理的影响充其量是不一致的。

启示

需要进一步研究以最终确定mHealth干预措施对HF结局的影响。在设计未来研究时应考虑当前研究的局限性(例如样本量不足、准实验设计、使用较旧的手机型号等)。

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