一种用于阻塞性睡眠呼吸暂停患者 CPAP 治疗的远程监测系统：参与式分析、设计和评估方法。
A telemonitoring system to support CPAP therapy in patients with obstructive sleep apnea: a participatory approach in analysis, design, and evaluation.
机构信息
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Faculty of Medicine, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
BMC Med Inform Decis Mak. 2022 Jun 26;22(1):168. doi: 10.1186/s12911-022-01912-8.
BACKGROUND
Continues positive airway pressure (CPAP) therapy is a gold standard treatment for moderate to severe cases of OSA (obstructive sleep apnea). The present research aimed to describe the analysis, design, and evaluation of a telemonitoring system to improve CPAP adherence in patients afflicted with OSA.
METHODS
The telemonitoring system was developed in five phases. In the exploratory phase, the body of related literature was reviewed. Then a need analysis was conducted through a focus group discussion with sleep medicine specialists and sales company representatives and an interview with patients. The third phase involved data integration. Then the content and system development were done based on the previous phases. Finally, usability and functionality tests were used to evaluate the system.
RESULTS
The exploratory phase and the needs analysis were conducted by four sleep medicine specialists, two medical informatics specialists, six key figures of the sales companies, two system developers, and 46 patients in different phases. Based on the results obtained from the data integration phase, the telemonitoring system involved three main parts: a patient's application, a doctor's portal, a selling companies' portal (operator's portal) along with facilitating software for patients to send the CPAP data. Usability and functionality tests were given to 7 and 10 patients, respectively. The total number of usability issues reported by users in the evaluation process was 18, with an average of 2.5 issues per user. The installation problems, disrupted links and improper playing of videos were the main functionalities problems that were solved.
CONCLUSION
The telemonitoring system, as a means of communication between patients, doctors, and selling companies, can be used to support patients clinically and technically. It has the potential to improve CPAP adherence in patients with OSA.
背景
持续气道正压通气（CPAP）治疗是中重度阻塞性睡眠呼吸暂停（OSA）的金标准治疗方法。本研究旨在描述一种远程监测系统的分析、设计和评估，以提高 OSA 患者的 CPAP 依从性。
方法
远程监测系统分五个阶段开发。在探索阶段，回顾了相关文献。然后通过与睡眠医学专家和销售公司代表进行焦点小组讨论以及对患者进行访谈进行需求分析。第三阶段涉及数据集成。然后根据前几个阶段的内容和系统开发。最后，使用可用性和功能测试来评估系统。
结果
探索阶段和需求分析由四名睡眠医学专家、两名医学信息学专家、六名销售公司的关键人物、两名系统开发人员和 46 名不同阶段的患者进行。基于数据集成阶段的结果，远程监测系统涉及三个主要部分：患者应用程序、医生门户、销售公司门户（操作员门户）以及为患者发送 CPAP 数据提供便利的软件。分别对 7 名和 10 名患者进行了可用性和功能测试。在评估过程中，用户报告的总可用性问题为 18 个，每个用户平均 2.5 个问题。安装问题、链接中断和视频播放不当是主要的功能问题，已经得到解决。
结论
远程监测系统作为患者、医生和销售公司之间的沟通手段，可以用于在临床和技术上支持患者。它有可能提高 OSA 患者的 CPAP 依从性。
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