为什么患者随着时间的推移停止使用家庭远程医疗技术：心力衰竭退伍军人中断使用的预测因素。
Why patients stop using their home telehealth technologies over time: Predictors of discontinuation in Veterans with heart failure.
机构信息
VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA; Southern Arizona VA Healthcare System, Tucson, AZ.
VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA.
出版信息
Nurs Outlook. 2021 Mar-Apr;69(2):159-166. doi: 10.1016/j.outlook.2020.11.004. Epub 2020 Dec 2.
BACKGROUND
Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear.
PURPOSE
To examine predictors of drop-out from HT in Veterans with heart failure.
METHODS
Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period.
FINDINGS
Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out.
DISCUSSION
Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement.
背景
家庭远程医疗（HT）技术的日常使用会随着时间的推移而减少。持续使用的障碍尚不清楚。
目的
研究退伍军人心力衰竭患者从 HT 中退出的预测因素。
方法
使用混合效应 Cox 回归模型分析了心力衰竭退伍军人的 HT 计划数据，以确定在 1 年内退出的风险。
结果
年龄较大（风险比[HR] 1.01）、病情较重（既往住院再入院[HR 1.39]）、更高的住院/死亡风险[HR 1.23]）和功能障碍（HR 1.14））以及白人退伍军人（与黑人相比；HR 1.41）在 HT 计划中更有可能停止使用 HT。使用 VA 在线患者门户的用户（HR 0.90）停止使用 HT 的风险较低。
讨论
年龄较大和病情较重的患者最有可能停止使用 HT，但使用患者门户有望改善持续使用。需要针对 HT 中断高风险患者的干预措施，以促进持续参与。
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