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移动医疗保健应用程序和人类教练计划在初级保健诊所中的有效性:多中心真实世界研究试点。

The Effectiveness of a Mobile Health Care App and Human Coaching Program in Primary Care Clinics: Pilot Multicenter Real-World Study.

机构信息

Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.

出版信息

JMIR Mhealth Uhealth. 2022 May 6;10(5):e34531. doi: 10.2196/34531.

Abstract

BACKGROUND

As the global burden of chronic conditions increases, their effective management is a concern. Although the need for chronic disease management using mobile self-management health care apps is increasing, there are still many barriers to their practical application in the primary care field.

OBJECTIVE

This study evaluated the effectiveness of primary care services combining a mobile self-management health care app with human coaching for patients with chronic diseases in the current primary care system.

METHODS

A total of 110 patients (mean age 53.2, SD 9.2 years; 64 of 110, 58.2% female) with hypertension, diabetes, dyslipidemia, or metabolic syndrome who visited one of 17 participating primary care clinics from September to November 2020 were included in this study. All participants recorded data regarding changes in body weight, sleep conditions, quality of life, depression, anxiety, stress, BMI, waist circumference, blood sugar levels, blood pressure, and blood lipids levels. The app user group (n=65) used a mobile self-management health care app with human coaching for 12 weeks, and the control group (n=45) underwent conventional self-managed health care.

RESULTS

Patients in the app user group reported significantly more weight loss than those in the control group-the body weight of the app user group decreased by 1.43 kg (95% CI -2.07 to -0.79) and that of the control group decreased by 0.13 kg (95% CI -0.67 to 0.41; P=.002). The weight loss was markedly greater after using the app for 9 weeks than that when used for 4 weeks or 5-8 weeks (P=.002). Patients in the app user group reported better sleep quality (P=.04) and duration (P=.004) than those in the control group.

CONCLUSIONS

The combination of primary care clinics and a mobile self-management health care app with human coaching results in better management of chronic conditions. This study shows that the primary care services combining a mobile self-management health care app with human coaching are effective in the current primary care system. An implication of this study is the possibility that a mobile self-management health care app with human coaching is a treatment option in the current primary care system.

摘要

背景

随着慢性病全球负担的增加,对其进行有效管理受到关注。尽管使用移动自我管理式医疗保健应用程序进行慢性病管理的需求不断增加,但在初级保健领域实际应用仍存在诸多障碍。

目的

本研究评估了在当前初级保健系统中,将移动自我管理式医疗保健应用程序与人工辅导相结合的初级保健服务对慢性病患者的效果。

方法

本研究共纳入 2020 年 9 月至 11 月期间来自 17 家参与初级保健诊所的 110 名患者(平均年龄 53.2 岁,标准差 9.2 岁;110 名患者中 64 名,58.2%为女性),他们患有高血压、糖尿病、血脂异常或代谢综合征。所有参与者均记录了体重变化、睡眠状况、生活质量、抑郁、焦虑、压力、BMI、腰围、血糖水平、血压和血脂水平的数据。应用程序用户组(n=65)使用带有人工辅导的移动自我管理式医疗保健应用程序 12 周,对照组(n=45)接受常规自我管理式保健。

结果

应用程序用户组的患者体重减轻量明显多于对照组,应用程序用户组体重减轻 1.43kg(95%置信区间:-2.07 至 -0.79),对照组体重减轻 0.13kg(95%置信区间:-0.67 至 0.41;P=.002)。使用应用程序 9 周后体重减轻量明显大于使用 4 周或 5-8 周后(P=.002)。应用程序用户组患者的睡眠质量(P=.04)和持续时间(P=.004)均优于对照组。

结论

初级保健诊所与带有人工辅导的移动自我管理式医疗保健应用程序相结合,可更好地管理慢性病。本研究表明,在当前初级保健系统中,将移动自我管理式医疗保健应用程序与人工辅导相结合的初级保健服务是有效的。该研究的一个意义是,带有人工辅导的移动自我管理式医疗保健应用程序可能成为当前初级保健系统中的一种治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23b7/9123543/d09a7daf15b1/mhealth_v10i5e34531_fig1.jpg

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