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远程患者监测:系统评价

Remote Patient Monitoring: A Systematic Review.

作者信息

Farias Frederico Arriaga Criscuoli de, Dagostini Carolina Matté, Bicca Yan de Assunção, Falavigna Vincenzo Fin, Falavigna Asdrubal

机构信息

Cell Therapy Laboratory (LATEC), and University of Caxias do Sul (UCS), Caxias do Sul, Rio Grande do Sul, Brazil.

Health Sciences Postgraduate Program, University of Caxias do Sul (UCS), Caxias do Sul, Rio Grande do Sul, Brazil.

出版信息

Telemed J E Health. 2020 May;26(5):576-583. doi: 10.1089/tmj.2019.0066. Epub 2019 Jul 17.

Abstract

Remote patient monitoring or telemonitoring aims at improving patient care through digitally transmitted health-related data. That allows early detection of disease decompensation and intervention, patient education and improves patientphysician relationship. Despite its relevance, there are no comprehensive reviews evaluating the variables discussed by clinical studies on telemonitoring. A systematic literature search of PubMed was performed to identify studies about telemonitoring published between 2000 and 2018. These had to be case reports with >5 cases, comparative or clinical studies/trials. The following variables were evaluated: year of publication, author's country, discussed topic, objective of study, follow-up time, number of telemonitoring patients, primary outcome, use of teleconsultation and tele-education, presence of a control group, effectiveness of telemonitoring, telemonitoring strategies, and level of evidence. After screening 947 records, 272 articles were included. The review showed a growing number of publications over the years, with 43.0% being published between 2015 and 2018, providing generally positive results (76.8%). The United States was responsible for 38.2% of articles. Cardiovascular disease was the topic of 47.8% of studies, whereas surgical pathologies and postoperative care represented only 2.6%. Wireless devices or smartphone apps were the most popular strategy (75.7%), with 17.6% of studies employing tele-education and 24.6% employing teleconsultation measures. Most publications were OCEBM Level of Evidence 2 (73.5%). Telemonitoring appears to maximize patient care and effectiveness of treatment. The number of publications illustrates the growing interest in the matter. Telemonitoring has yet to be evaluated in the setting of postoperative care and surgical pathologies.

摘要

远程患者监测或远程监控旨在通过数字传输的健康相关数据改善患者护理。这有助于早期发现疾病失代偿并进行干预、开展患者教育并改善医患关系。尽管其具有相关性,但尚无全面的综述来评估临床研究中关于远程监控所讨论的变量。我们对PubMed进行了系统的文献检索,以识别2000年至2018年间发表的有关远程监控的研究。这些研究必须是病例报告(病例数>5)、比较性或临床研究/试验。评估了以下变量:发表年份、作者所在国家、讨论的主题、研究目的、随访时间、远程监控患者数量、主要结局、远程会诊和远程教育的使用情况、是否存在对照组、远程监控的有效性、远程监控策略以及证据水平。在筛选了947条记录后,纳入了272篇文章。综述显示,多年来发表的文章数量不断增加,其中43.0%发表于2015年至2018年,总体结果呈阳性(76.8%)。美国的文章占38.2%。47.8%的研究主题是心血管疾病,而外科病理学和术后护理仅占2.6%。无线设备或智能手机应用是最受欢迎的策略(75.7%),17.6%的研究采用了远程教育,24.6%的研究采用了远程会诊措施。大多数出版物为循证医学中心(OCEBM)证据水平2(73.5%)。远程监控似乎能使患者护理和治疗效果最大化。出版物数量表明人们对该问题的兴趣日益浓厚。远程监控在术后护理和外科病理学方面尚未得到评估。

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