1 General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
2 Department of Psychology, University of Southampton, Highfield, Southampton, UK.
Chron Respir Dis. 2017 Nov;14(4):407-419. doi: 10.1177/1479972316660977. Epub 2016 Aug 10.
Long-term respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common, and cause high levels of morbidity and mortality. Supporting self-management is advocated for both asthma and increasingly so for COPD, and there is growing interest in the potential role of a range of new technologies, such as smartphone apps, the web or telehealth to facilitate and promote self-management in these conditions. Treatment goals for both asthma and COPD include aiming to control symptoms, maintain activities, achieve the best possible quality of life and minimize risks of exacerbation. To do this, health professionals should be (a) helping patients to recognize deteriorating symptoms and act appropriately; (b) promoting adherence to maintenance therapy; (c) promoting a regular review where triggers can be established, and strategies for managing such triggers discussed; and (d) promoting healthy lifestyles and positive self-management of symptoms. In particular, low uptake of asthma action plans is a modifiable contributor to morbidity and possibly also to mortality in those with asthma and should be addressed as a priority. Using technology to support self-management is an evolving strategy that shows promise. This review provides an overview of self-management support and discusses how newer technologies may help patients and health professionals to meet key treatment goals.
长期的呼吸系统疾病,如哮喘和慢性阻塞性肺疾病(COPD)较为常见,会导致高发病率和高死亡率。提倡对哮喘和 COPD 进行自我管理,而对于利用各种新技术(如智能手机应用程序、网络或远程医疗)来促进这些疾病的自我管理,人们的兴趣日益浓厚。哮喘和 COPD 的治疗目标都包括:控制症状、维持活动能力、达到尽可能好的生活质量并将恶化风险降到最低。为了实现这一目标,医疗保健专业人员应:(a)帮助患者识别病情恶化的症状并采取适当的措施;(b)促进坚持维持治疗;(c)定期进行病情审查,确定触发因素并讨论应对这些触发因素的策略;(d)促进健康的生活方式和积极的自我管理症状。特别是,哮喘行动计划的低采用率是导致哮喘患者发病率升高的可改变因素,也可能导致死亡率升高,应作为优先事项予以解决。利用技术支持自我管理是一种不断发展的策略,具有广阔的前景。本文综述了自我管理支持,并讨论了新技术如何帮助患者和医疗保健专业人员实现关键的治疗目标。