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一项以患者为中心、基于计算机的自我监测系统用于 2 型糖尿病和高血压护理的 3 个月随机对照试验

A 3-Month Randomized Controlled Pilot Trial of a Patient-Centered, Computer-Based Self-Monitoring System for the Care of Type 2 Diabetes Mellitus and Hypertension.

机构信息

Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Room 8-7, 8/f., Haking Wong Building, Pokfulam, Hong Kong, China.

Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China.

出版信息

J Med Syst. 2016 Apr;40(4):81. doi: 10.1007/s10916-016-0437-1. Epub 2016 Jan 22.

DOI:10.1007/s10916-016-0437-1
PMID:26802011
Abstract

This study was performed to evaluate the effects of a patient-centered, tablet computer-based self-monitoring system for chronic disease care. A 3-month randomized controlled pilot trial was conducted to compare the use of a computer-based self-monitoring system in disease self-care (intervention group; n = 33) with a conventional self-monitoring method (control group; n = 30) in patients with type 2 diabetes mellitus and/or hypertension. The system was equipped with a 2-in-1 blood glucose and blood pressure monitor, a reminder feature, and video-based educational materials for the care of the two chronic diseases. The control patients were given only the 2-in-1 monitor for self-monitoring. The outcomes reported here included the glycated hemoglobin (HbA1c) level, fasting blood glucose level, systolic blood pressure, diastolic blood pressure, chronic disease knowledge, and frequency of self-monitoring. The data were collected at baseline and at 1-, 2-, and 3-month follow-up visits. The patients in the intervention group had a significant decrease in mean systolic blood pressure from baseline to 1 month (p < 0.001) and from baseline to 3 months (p = 0.043) compared with the control group. Significant improvements in the mean diastolic blood pressure were seen in the intervention group compared with the control group after 1 month (p < 0.001) and after 2 months (p = 0.028), but the change was not significant after 3 months. No significant differences were observed between the groups in the fasting blood glucose level, the HbA1c level, or chronic disease knowledge. The frequency of self-monitoring of blood glucose level and blood pressure was similar in both groups. The performances of the tablet computer-assisted and conventional disease self-monitoring appear to be useful to support/maintain blood pressure and diabetes control. The beneficial effects of the use of electronic self-care resources and support provided via mobile technologies require further confirmation in longer-term, larger trials.

摘要

这项研究旨在评估基于平板电脑的以患者为中心的自我监测系统在慢性病管理中的效果。进行了为期 3 个月的随机对照试验,比较了使用基于计算机的自我监测系统进行疾病自我管理(干预组;n = 33)与使用传统自我监测方法(对照组;n = 30)在 2 型糖尿病和/或高血压患者中的效果。该系统配备了血糖仪和血压计、提醒功能以及两种慢性病护理的视频教育资料。对照组仅给予 2 合 1 监测器进行自我监测。此处报告的结果包括糖化血红蛋白(HbA1c)水平、空腹血糖水平、收缩压、舒张压、慢性病知识和自我监测频率。数据在基线以及 1、2 和 3 个月随访时收集。与对照组相比,干预组患者的平均收缩压从基线到 1 个月(p < 0.001)和从基线到 3 个月(p = 0.043)均显著下降。与对照组相比,干预组患者的平均舒张压在 1 个月后(p < 0.001)和 2 个月后(p = 0.028)显著改善,但 3 个月后差异无统计学意义。两组患者的空腹血糖水平、HbA1c 水平或慢性病知识均无显著差异。两组患者自我监测血糖和血压的频率相似。平板电脑辅助与传统疾病自我监测的表现似乎有助于维持血压和糖尿病控制。使用电子自我护理资源和移动技术提供的支持的有益效果需要在更长时间、更大规模的试验中进一步确认。

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