基于 IVRS 的移动医疗干预在降低代谢综合征心血管风险中的效果：一项集群随机试验。

Efficacy of IVRS-based mHealth intervention in reducing cardiovascular risk in metabolic syndrome: A cluster randomized trial.

机构信息

Departments of Community Medicine, RUHS College of Medical Sciences, Jaipur, 302033, India.

出版信息

Diabetes Metab Syndr. 2021 Sep-Oct;15(5):102182. doi: 10.1016/j.dsx.2021.06.019. Epub 2021 Jun 21.

DOI:10.1016/j.dsx.2021.06.019

PMID:34330073

Abstract

AIMS

Efficacy of mobile-phone based intervention for reducing cardiovascular risk in metabolic syndrome (MetSyn).

METHODS

We screened adults 20-60 years in 10 villages in India for MetSyn using stratified cluster sampling. Lifestyle and biochemical risk factors were assessed. International Harmonized Criteria were used for diagnosis. Villages were randomized with 5 each in control and intervention groups. Interactive voice response system (IVRS) in Hindi was developed. In intervention clusters two messages for promotion of healthy lifestyle and medical treatment were broadcast daily over 12-months and risk factors reassessed.

RESULTS

1012/1200(84%) persons were screened and MetSyn diagnosed in 286(28.3%). Villages were divided into 5 control(n = 136) and 5 intervention(n = 147) clusters. Baseline characteristics in both clusters were similar. Acceptability of intervention was >60% in 80% participants. At 12 months, significantly greater participants in intervention vs control clusters had healthier lifestyle (healthy diet 28.8vs14.7%, physical activity 25.9vs13.1%, tobacco 13.7vs32.5%), anthropometry (waist circumference 85.7 ± 6.3vs88.6 ± 14.0 cm, body mass index 21.9 ± 2.8vs23.1 ± 2.9 kg/m), systolic BP 123.6 ± 7.7vs128.6 ± 14.1 mmHg, fasting glucose 95.6 ± 19.4vs109.4 ± 43.7 mg/dl, cholesterol 175.5 ± 36.5vs186.4 ± 43.3 mg/dl, and triglycerides 147.6 ± 48.3vs159.5 ± 60.7 mg/dl (p < 0.01). Prevalence of metabolic syndrome declined in intervention group by 22.3%vs3.9%, p < 0.001).

CONCLUSION

An interactive voice response system based technology significantly reduced multiple cardiovascular risk factors and prevalence of metabolic syndrome.

摘要

目的

评估基于手机的干预措施在降低代谢综合征（MetSyn）患者心血管风险方面的疗效。

方法

我们采用分层聚类抽样的方法，在印度的 10 个村庄筛选年龄在 20-60 岁之间的成年人，以评估生活方式和生化风险因素。采用国际协调标准进行诊断。将村庄随机分为对照组和干预组，每组 5 个。开发了印度语互动语音应答系统（IVRS）。在干预组中，每天通过 IVRS 广播两条关于促进健康生活方式和接受医学治疗的信息，持续 12 个月，并重新评估风险因素。

结果

在 1200 名接受筛查的人中，有 1012 人（84%）患有 MetSyn。在 286 名患者中（28.3%）诊断为 MetSyn。将村庄分为 5 个对照组（n=136）和 5 个干预组（n=147）。两组的基线特征相似。在 80%的参与者中，干预措施的可接受性>60%。在 12 个月时，与对照组相比，干预组有更多的参与者拥有更健康的生活方式（健康饮食 28.8% vs 14.7%，体力活动 25.9% vs 13.1%，吸烟 13.7% vs 32.5%）、更好的人体测量学指标（腰围 85.7±6.3 cm vs 88.6±14.0 cm，体重指数 21.9±2.8 kg/m2 vs 23.1±2.9 kg/m2）、更低的收缩压（123.6±7.7 mmHg vs 128.6±14.1 mmHg）、更低的空腹血糖（95.6±19.4 mg/dl vs 109.4±43.7 mg/dl）、更低的胆固醇（175.5±36.5 mg/dl vs 186.4±43.3 mg/dl）和更低的甘油三酯（147.6±48.3 mg/dl vs 159.5±60.7 mg/dl）（p<0.01）。干预组的代谢综合征患病率下降了 22.3%（p<0.001）。