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针对哮喘儿童生活质量的研究:MyTEP 试验的随机试点研究。

Targeting quality of life in asthmatic children: The MyTEP pilot randomized trial.

机构信息

Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy.

Dipartimento di Scienze per la Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy.

出版信息

Respir Med. 2019 Jul;153:14-19. doi: 10.1016/j.rmed.2019.05.008. Epub 2019 May 17.

Abstract

BACKGROUND

Quality of life (QoL) is an important outcome in the management of children with asthma. Mobile Health (m-Health) and Therapeutic Education Programs (TEPs) are increasingly recognized as essential components of pediatric asthma management to improve disease outcomes.

OBJECTIVE

To evaluate the effect of an education program (MyTherapeutic Education Program, MyTEP) that couples multidisciplinary TEP intervention with an m-Health Program (mHP) in improving QoL in asthmatic children.

METHODS

This single-center study employed a nonblinded randomized clinical trial design. Italian-speaking children (6-11 years) with mild-moderate asthma were eligible for participation. Participants were randomly paired 1:1 with a control group that received mHP (smartphone app) or an intervention group that received MyTEP (TEP plus a smartphone app). Patients were followed up for 3 months. Descriptive statistics, Least Square (LS) mean change and Generalized Linear Mixed model were used for analysis.

RESULTS

Fifty patients were enrolled. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) score improved in both MyTEP (p = 0.014) and mHP (p = 0.046) with the minimally clinically significant difference of ⩾0.5 points reached in 23% of MyTEP and in 16% of mHP. Changes in PAQLQ scores were significantly greater in MyTEP than in mHP (LS mean difference: 0.269 p = 0.05). PAQLQ score was: positively associated with MyTEP (p = 0.023) and study time (p = 0.002); and inversely associated with current passive smoke exposure (p = 0.003).

CONCLUSION

Despite the small sample size and short observation period, this study demonstrated that implementing a multidisciplinary TEP with an m-Health program results in gains in QoL of children with asthma.

摘要

背景

生活质量(QoL)是儿童哮喘管理的重要结果。移动健康(m-Health)和治疗教育计划(TEP)越来越被认为是改善疾病结果的儿科哮喘管理的重要组成部分。

目的

评估将多学科 TEP 干预与 m-Health 计划(mHP)相结合的教育计划(MyTherapeutic Education Program,MyTEP)对改善哮喘儿童生活质量的效果。

方法

这项单中心研究采用非盲随机临床试验设计。患有轻度至中度哮喘的讲意大利语的儿童有资格参加。参与者按 1:1 与对照组随机配对,对照组接受 mHP(智能手机应用程序)或干预组接受 MyTEP(TEP 加智能手机应用程序)。对患者进行了 3 个月的随访。采用描述性统计、最小二乘(LS)均值变化和广义线性混合模型进行分析。

结果

共纳入 50 名患者。MyTEP(p=0.014)和 mHP(p=0.046)的儿科哮喘生活质量问卷(PAQLQ)评分均有所改善,MyTEP 中有 23%的患者和 mHP 中有 16%的患者达到了最小临床显著差异≥0.5 分。MyTEP 组的 PAQLQ 评分变化明显大于 mHP 组(LS 均值差异:0.269,p=0.05)。PAQLQ 评分与 MyTEP(p=0.023)和研究时间(p=0.002)呈正相关,与当前被动吸烟暴露(p=0.003)呈负相关。

结论

尽管样本量小且观察期短,但本研究表明,实施多学科 TEP 与 m-Health 计划相结合可提高哮喘儿童的生活质量。

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