个性化远程医疗干预在慢性病管理中的应用：一项试点随机对照试验。
Personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial.
机构信息
1 Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Australia.
2 Barwon Health, University Hospital Geelong, Geelong, Australia.
出版信息
J Telemed Telecare. 2019 Jul;25(6):343-352. doi: 10.1177/1357633X18775850. Epub 2018 May 24.
INTRODUCTION
The aim of this study was to assess the impact of home-based telehealth monitoring on health outcomes, quality of life and costs over 12 months for patients with diabetes and/or chronic obstructive pulmonary disease (COPD) who were identified as being at high risk of readmission to hospital.
METHODS
This pilot study was a randomised controlled trial combined with an economic analysis to examine the outcomes of standard care versus home-based telehealth for people with diabetes and/or COPD who were at risk of hospital readmission within one year. The primary outcomes were (i) hospital admission and length of stay (LOS); and (ii) health-related quality of life (HRQOL); and the secondary outcomes were (i) health-related clinical outcomes; (ii) anxiety and depression scores; and (iii) health literacy. The costs of the intervention and hospitalisations were included.
RESULTS
A total of 86 and 85 participants were randomised to the intervention and control groups respectively. The difference between groups in hospital LOS was -3.89 (95% confidence interval (CI): -9.40, 1.62) days, and for HRQOL, 0.09 (95% CI: 0.05, 0.14) in favour of the telehealth monitoring group. There was a saving of AUD$6553 (95% CI: -12145, -961) in the cost of hospitalisation over 12 months, which offset the increased cost of tele-monitoring. The intervention group showed an improvement in anxiety, depression and health literacy at 12 months, and in the diabetes group, a reduction in microalbuminuria.
DISCUSSION
The telehealth monitoring intervention improved patient's health outcomes and quality of life at no additional cost.
介绍
本研究旨在评估家庭远程健康监测对糖尿病和/或慢性阻塞性肺疾病（COPD）高危患者在 12 个月内健康结局、生活质量和成本的影响，这些患者有再次住院的风险。
方法
这是一项随机对照试验，结合经济分析，评估了标准护理与家庭远程健康监测对一年内有住院风险的糖尿病和/或 COPD 患者的效果。主要结局为（i）住院和住院时间（LOS）；（ii）健康相关生活质量（HRQOL）；次要结局为（i）健康相关临床结局；（ii）焦虑和抑郁评分；（iii）健康素养。包括干预和住院费用。
结果
共有 86 名和 85 名参与者分别随机分配到干预组和对照组。组间 LOS 差异为-3.89（95%置信区间（CI）：-9.40，1.62）天，HRQOL 差异为 0.09（95% CI：0.05，0.14），有利于远程健康监测组。12 个月内住院费用节省了 6553 澳元（95% CI：-12145，-961），这抵消了远程监测的增加成本。干预组在 12 个月时焦虑、抑郁和健康素养有所改善，糖尿病组的微量白蛋白尿减少。
讨论
远程健康监测干预改善了患者的健康结局和生活质量，且没有增加额外成本。
Zotero 插件