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针对先天性心脏病的定制化数字应用平台的患者监测和教育:一项可行性试点研究。

Patient monitoring and education over a tailored digital application platform for congenital heart disease: A feasibility pilot study.

机构信息

Adult Congenital Heart Centre, Royal Brompton Hospital, Guys & St Thomas's Foundation Trust, United Kingdom; National Heart and Lung Institute, , Imperial College London, United Kingdom.

Adult Congenital Heart Centre, Royal Brompton Hospital, Guys & St Thomas's Foundation Trust, United Kingdom.

出版信息

Int J Cardiol. 2022 Sep 1;362:68-73. doi: 10.1016/j.ijcard.2022.05.002. Epub 2022 May 6.

Abstract

BACKGROUND

Patients with adult congenital heart disease (ACHD) are a rapidly growing cardiovascular population with increasing health needs and co-morbidities. Furthermore, their management requires frequent and ongoing hospital visits which can be burdensome. Digital health and remote monitoring have been shown to have a vast potential to enhance delivery of healthcare for patients, reducing their need for travel to clinic appointments therefore reducing costs to the patient and the healthcare service.

METHODS

Patients over the age of 16 with a diagnosis of ACHD were invited to use the tailored digital application too. They were monitored for a period of 6 months. Information on patient demographics, time using the application, flagged events that prompted clinical reviews and their feedback through patient surveys were collected.

RESULTS

A total of 103 patients were enrolled and registered to use the digital application tool. There were 57 (56%) males, median age at the time of enrolment was 39 (16-73) years. The majority (96%) had a moderate or complex ACHD according to the ACC/AHA classification. There was a total of 7 modules that were completed on a weekly basis. The median length of a participant session was 2.2 min and the mean time to complete a module was 21 s. In total, 35 (67%) felt that the application helped them better manage their cardiac condition. Almost all (94%) of patients expressed that they would like to continue using the application beyond the pilot. There were 18 flagged events during the 6 month observation period, and 50% of received early clinical intervention.

CONCLUSION

Application based remote monitoring in this select group was well received and potentially holds large benefit to patients both clinically and economically. There were no safety concerns in our pilot feasibility study. Our data may inform much needed and timely investment in digital health.

摘要

背景

成人先天性心脏病(ACHD)患者是心血管疾病患者中人数增长最快的群体,他们的健康需求和合并症不断增加。此外,他们的管理需要频繁且持续的医院就诊,这可能会带来负担。数字健康和远程监测已被证明具有巨大的潜力,可以改善患者的医疗服务,减少他们前往诊所就诊的需求,从而降低患者和医疗服务的成本。

方法

邀请年龄在 16 岁以上的 ACHD 患者使用定制的数字应用程序。他们被监测了 6 个月。收集了患者人口统计学信息、使用应用程序的时间、触发临床审查的标记事件以及通过患者调查获得的反馈。

结果

共有 103 名患者入组并注册使用数字应用程序工具。其中 57 名(56%)为男性,入组时的中位年龄为 39 岁(16-73 岁)。根据 ACC/AHA 分类,大多数(96%)患者患有中度或复杂的 ACHD。每周完成总共 7 个模块。参与者的会话中位数长度为 2.2 分钟,完成一个模块的平均时间为 21 秒。共有 35 名(67%)患者认为该应用程序有助于他们更好地管理心脏状况。几乎所有(94%)患者都表示愿意在试点项目结束后继续使用该应用程序。在 6 个月的观察期间,共标记了 18 个事件,其中 50%的患者得到了早期临床干预。

结论

在这个选择的患者群体中,基于应用程序的远程监测得到了很好的接受,并且在临床和经济方面都可能对患者有很大的益处。在我们的可行性试点研究中,没有安全问题。我们的数据可能为数字健康的急需和及时投资提供信息。

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