基于信息技术的干预措施改善慢性肾脏病患者自我管理的特点和效果:文献系统评价。
Features and Effects of Information Technology-Based Interventions to Improve Self-Management in Chronic Kidney Disease Patients: a Systematic Review of the Literature.
机构信息
Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Department of Health Information Management & Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran.
出版信息
J Med Syst. 2017 Sep 18;41(11):170. doi: 10.1007/s10916-017-0820-6.
Slowing down the progression of chronic kidney disease (CKD) and its adverse health outcomes requires the patient's self-management and attention to treatment recommendations. Information technology (IT)-based interventions are increasingly being used to support self-management in patients with chronic diseases such as CKD. We conducted a systematic review of randomized controlled trials (RCTs) to assess the features and effects of IT-based interventions on self-management outcomes of CKD patients. A comprehensive search was conducted in Medline, Scopus, and the Cochrane Library to identify relevant papers that were published until May 2016. RCT Studies that assessed at least one automated IT tool in patients with CKD stages 1 to 5, and reported at least one self-management outcome were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment tool. Out of 12,215 papers retrieved, eight study met the inclusion criteria. Interventions were delivered via smartphones/personal digital assistants (PDAs) (three studies), wearable devices (three studies), computerized systems (one study), and multiple component (one study). The studies assessed 15 outcomes, including eight clinical outcomes and seven process of care outcomes. In 12 (80%) of the 15 outcomes, the studies had revealed the effects of the interventions as statistically significant positive. These positive effects were observed in 75% of the clinical outcomes and 86% of the process of care outcomes. The evidence indicates the potential of IT-based interventions (i.e. smartphones/PDAs, wearable devices, and computerized systems) in self-management outcomes (clinical and process of care outcomes) of CKD patients.
减缓慢性肾脏病(CKD)的进展及其不良健康后果需要患者进行自我管理并关注治疗建议。信息技术(IT)为基础的干预措施越来越多地被用于支持慢性疾病(如 CKD)患者的自我管理。我们对随机对照试验(RCT)进行了系统回顾,以评估基于 IT 的干预措施对 CKD 患者自我管理结果的特征和效果。在 Medline、Scopus 和 Cochrane 图书馆中进行了全面检索,以确定截至 2016 年 5 月发表的相关论文。纳入评估 CKD 1 至 5 期患者中至少一种自动化 IT 工具并报告至少一项自我管理结果的 RCT 研究。使用 Cochrane 偏倚风险评估工具对研究进行质量评估。在检索到的 12215 篇论文中,有 8 项研究符合纳入标准。干预措施通过智能手机/个人数字助理(PDA)(3 项研究)、可穿戴设备(3 项研究)、计算机系统(1 项研究)和多种组件(1 项研究)进行。这些研究评估了 15 个结果,包括 8 个临床结果和 7 个护理过程结果。在 15 个结果中的 12 个(80%)中,研究显示干预措施的效果具有统计学意义的阳性。在 75%的临床结果和 86%的护理过程结果中观察到这些积极效果。证据表明基于 IT 的干预措施(即智能手机/PDA、可穿戴设备和计算机系统)在 CKD 患者的自我管理结果(临床和护理过程结果)方面具有潜力。