Zhu Ce, Wu Qiang, Xiao Bing, Wang Juehan, Luo Chao, Yu Quan, Liu Limin, Song Yueming
Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.
Department of Spine Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
BMC Musculoskelet Disord. 2021 Feb 5;22(1):152. doi: 10.1186/s12891-021-03976-5.
Patient compliance is essential to the effectiveness of brace treatment for adolescent idiopathic scoliosis (AIS) patients. Subjective measurements like questionnaires and inquiries proved to be arguably inaccurate. Although some scholars have applied temperature/force monitors to measuring patient compliance objectively, few studies to date could monitor patient compliance in real time. The objective of this study is to describe and evaluate a compliance real-time monitoring system of the brace usage in AIS patients.
A compliance real-time monitoring system (specifically consisting of a compliance monitor, a WeChat Mini Program, a cloud-based storage system and a website backstage management system) was designed to manage the brace treatment. Thirty patients receiving brace treatment were enrolled. They were told to upload the data at least once a day. Clinicians downloaded the compliance data and communicated with the patients online based on their analysis of data at least once every 3 months. The measured force, quality compliance (measured force / baseline force), measured time, and quantity compliance (measured time/ prescribed time) were used to evaluate patient compliance. Patients were also asked to rate their satisfaction at the final follow-up.
Twenty-eight patients were included in the final analysis. The mean baseline force was 1.23 ± 0.28 N. The mean measured force was 0.79 ± 0.29 N. The mean quality compliance was 64.8 ± 22.2%. The prescribed time of all patients was 23 h. The mean measured time was 14.1 ± 2.9 h. The mean quantity compliance was 61.3 ± 12.6%. Both the quality and quantity compliance during the first 3 months of treatment was significantly lower than the latter 3 months. In this study, 96.4% (27/28) patients were satisfied with the use of the monitoring system, among whom 21.4% (6/28) are very satisfied and 75.0% (21/28) are somewhat satisfied.
The compliance real-time monitoring system, without evaluating the clinical and radiographic outcomes for now, has already shown some feasibility and effectiveness for the management of the brace usage in AIS patients. This system, as a useful tool for online patient management and patient-clinician communication, would be potentially employed on a large scale in future for clinicians to improve the compliance and satisfaction of AIS patients who have received brace treatment.
患者依从性对于青少年特发性脊柱侧凸（AIS）患者支具治疗的有效性至关重要。问卷调查和询问等主观测量方法被证明可能不准确。尽管一些学者已应用温度/力监测器来客观测量患者依从性，但迄今为止很少有研究能够实时监测患者依从性。本研究的目的是描述和评估一种AIS患者支具使用的依从性实时监测系统。
设计了一种依从性实时监测系统（具体由一个依从性监测器、一个微信小程序、一个基于云的存储系统和一个网站后台管理系统组成）来管理支具治疗。招募了30名接受支具治疗的患者。告知他们每天至少上传一次数据。临床医生下载依从性数据，并至少每3个月根据对数据的分析与患者进行一次在线沟通。使用测量力、质量依从性（测量力/基线力）、测量时间和数量依从性（测量时间/规定时间）来评估患者依从性。在最终随访时还要求患者对他们的满意度进行评分。
28名患者纳入最终分析。平均基线力为1.23±0.28N。平均测量力为0.79±0.29N。平均质量依从性为64.8±22.2%。所有患者的规定时间为23小时。平均测量时间为14.1±2.9小时。平均数量依从性为61.3±12.6%。治疗前3个月的质量和数量依从性均显著低于后3个月。在本研究中，96.4%（27/28）的患者对监测系统的使用感到满意，其中21.4%（6/28）非常满意，75.0%（21/28）有些满意。
该依从性实时监测系统目前虽未评估临床和影像学结果，但已显示出在管理AIS患者支具使用方面的一些可行性和有效性。作为一种用于在线患者管理和医患沟通的有用工具，该系统未来可能会被大规模应用，以提高接受支具治疗的AIS患者的依从性和满意度。
