Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Azadi Street, Mashhad, Iran.
Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
BMC Med Inform Decis Mak. 2021 Jan 2;21(1):2. doi: 10.1186/s12911-020-01360-2.
Kidney transplant outcomes are broadly associated with transplant recipients' capacity in following a complex and continuous self-management regimen. Health information technology has the potential to empower patients. This systematic review aimed to determine the impacts of IT-based interventions for self-management in kidney transplant recipients.
A comprehensive investigation was performed in MEDLINE (via PubMed) and EMBASE (via Scopus) in April 2019. Eligible studies were the randomized controlled trials which aimed to design an automated IT-based intervention. All English papers including adult kidney transplant recipients were included. To assess the clinical trial's quality, Cochrane Collaboration's assessment tool was employed. The articles were integrated based on category of outcomes, characteristics of interventions, and their impact. The interventions were classified based on the used IT-based tools, including smart phones, coverage tools, computer systems, and a combination of several tools. The impact of interventions was defined as: (1) positive effect (i.e. statistically significant), and (2) no effect (i.e. not statistically significant).
A total of 2392 articles were retrieved and eight publications were included for full-text analysis. Interventions include those involving the use of computerized systems (3 studies), smart phone application (3 studies), and multiple components (2 studies). The studies evaluated 30 outcomes in total, including 24 care process and 6 clinical outcomes. In 18 (80%) out of 30 outcomes, interventions had a statistically significant positive effect, 66% in process and 33% in clinical outcomes.
IT-based interventions (e.g. mobile health applications, wearable devices, and computer systems) can improve self-management in kidney transplant recipients (including clinical and care process outcomes). However, further evaluation studies are required to quantify the impact of IT-based self-management interventions on short- and long-term clinical outcomes as well as health care costs and patients' quality of life.
肾移植的结果与移植受者遵循复杂且持续的自我管理方案的能力广泛相关。健康信息技术有可能赋予患者权力。本系统评价旨在确定基于信息技术的自我管理干预措施对肾移植受者的影响。
2019 年 4 月，在 MEDLINE（通过 PubMed）和 EMBASE（通过 Scopus）中进行了全面调查。合格的研究是旨在设计自动化基于信息技术的干预措施的随机对照试验。所有英文论文均包括成年肾移植受者。为了评估临床试验的质量，使用了 Cochrane 协作组的评估工具。根据结果类别、干预措施的特征及其影响对文章进行了整合。根据使用的基于信息技术的工具对干预措施进行了分类，包括智能手机、覆盖工具、计算机系统和几种工具的组合。干预措施的影响定义为：（1）积极影响（即具有统计学意义），和（2）无影响（即无统计学意义）。
共检索到 2392 篇文章，有 8 篇文章进行了全文分析。干预措施包括涉及使用计算机系统（3 项研究）、智能手机应用程序（3 项研究）和多种组件（2 项研究）的干预措施。这些研究共评估了 30 项结果，包括 24 项护理过程和 6 项临床结果。在 30 项结果中的 18 项（80%）中，干预措施具有统计学上的积极影响，24%在护理过程中，33%在临床结果中。
基于信息技术的干预措施（例如移动健康应用程序、可穿戴设备和计算机系统）可以改善肾移植受者的自我管理（包括临床和护理过程结果）。然而，需要进一步的评估研究来量化基于信息技术的自我管理干预措施对短期和长期临床结果以及医疗保健成本和患者生活质量的影响。
