Amsterdam Rheumatology and Immunology Center, Reade, 1056 AA Amsterdam, The Netherlands.
VU Medical Center, Department of Rheumatology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands.
Int J Environ Res Public Health. 2021 Sep 27;18(19):10161. doi: 10.3390/ijerph181910161.
Effective telemonitoring is possible through repetitive collection of electronic patient-reported outcome measures (ePROMs) in patients with chronic diseases. Low adherence to telemonitoring may have a negative impact on the effectiveness, but it is unknown which factors are associated with adherence to telemonitoring by ePROMs. The objective was to identify factors associated with adherence to telemonitoring by ePROMs in patients with chronic diseases. A systematic literature search was conducted in PubMed, Embase, PsycINFO and the Cochrane Library up to 8 June 2021. Eligibility criteria were: (1) interventional and cohort studies, (2) patients with a chronic disease, (3) repetitive ePROMs being used for telemonitoring, and (4) the study quantitatively investigating factors associated with adherence to telemonitoring by ePROMs. The Cochrane risk of bias tool and the risk of bias in nonrandomized studies of interventions were used to assess the risk of bias. An evidence synthesis was performed assigning to the results a strong, moderate, weak, inconclusive or an inconsistent level of evidence. Five studies were included, one randomized controlled trial, two prospective uncontrolled studies and two retrospective cohort studies. A total of 15 factors potentially associated with adherence to telemonitoring by ePROMs were identified in the predominate studies of low quality. We found moderate-level evidence that sex is not associated with adherence. Some studies showed associations of the remaining factors with adherence, but the overall results were inconsistent or inconclusive. None of the 15 studied factors had conclusive evidence to be associated with adherence. Sex was, with moderate strength, not associated with adherence. The results were conflicting or indecisive, mainly due to the low number and low quality of studies. To optimize adherence to telemonitoring with ePROMs, mixed-method studies are needed.
有效的远程监测可以通过对慢性病患者重复收集电子患者报告结局测量（ePROMs）来实现。远程监测的低依从性可能会对其有效性产生负面影响，但尚不清楚哪些因素与 ePROMs 远程监测的依从性相关。本研究的目的是确定与慢性病患者 ePROMs 远程监测依从性相关的因素。
我们在 PubMed、Embase、PsycINFO 和 Cochrane Library 中进行了系统文献检索，检索时间截至 2021 年 6 月 8 日。纳入标准为：（1）干预性研究和队列研究；（2）慢性病患者；（3）重复使用 ePROMs 进行远程监测；（4）研究定量调查与 ePROMs 远程监测依从性相关的因素。我们使用 Cochrane 偏倚风险工具和干预措施非随机研究的偏倚风险评估工具来评估偏倚风险。我们对证据进行综合分析，将结果分为强、中、弱、不确定或不一致的证据水平。
纳入了 5 项研究，其中包括 1 项随机对照试验、2 项前瞻性非对照研究和 2 项回顾性队列研究。在这些质量较低的主要研究中，共确定了 15 个可能与 ePROMs 远程监测依从性相关的因素。我们发现，在性别方面，没有证据表明其与依从性相关。一些研究表明，其余因素与依从性有关，但总体结果不一致或不确定。
在研究的 15 个因素中，没有一个具有明确的证据表明其与依从性相关。性别与依从性无显著关联（中度证据）。由于研究数量少且质量低，结果存在冲突或不确定。为了提高 ePROMs 远程监测的依从性，需要开展混合方法研究。
