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SALUS 试验——比较青光眼患者自我眼压测量与定期住院眼压控制的非劣效性试验:研究设计与设置。

SALUS-a non-inferiority trial to compare self-tonometry in glaucoma patients with regular inpatient intraocular pressure controls: study design and set-up.

机构信息

Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany.

Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2022 Dec;260(12):3945-3955. doi: 10.1007/s00417-022-05759-7. Epub 2022 Jul 22.

Abstract

PURPOSE

The SALUS study aims to improve the healthcare situation for glaucoma patients in Germany. In order to detect diurnal intraocular pressure (IOP) fluctuations, inpatient monitoring of IOP in an eye hospital for a minimum of 24 h is the current standard. SALUS assesses the benefits of a new form of outpatient care, where IOP can be measured by the patients themselves at home using a self-tonometer. This approach should promote the patient's health competence and empowerment within the healthcare system while reducing treatment costs.

METHODS

The SALUS study is a randomized controlled, open non-inferiority trial, alongside an economic analysis, determining whether outpatient monitoring of IOP with self-tonometry is at least as effective as current standard care and would reduce treatment costs. Participants (n = 1980) will be recruited by local ophthalmologists in the area of Westphalia-Lippe, Germany, and randomized to receive 7-day outpatient or 24-h inpatient monitoring. Participants in both study arms will also receive 24-h blood pressure monitoring. Furthermore, patient data from both study groups will be collected in an electronic case file (ECF), accessible to practitioners, hospitals, and the study participants. The primary endpoint is the percentage of patients with IOP peaks, defined as levels 30% above the patient-specific target pressure. Data will also be collected during initial and final examinations, and at 3, 6, and 9 months after the initial examination.

RESULTS

The study implementation and trial management are represented below.

CONCLUSION

SALUS is a pioneering prospective clinical trial focused on the care of glaucoma patients in Germany. If SALUS is successful, it could improve the healthcare situation and health literacy of the patients through the introduction of various telemedical components. Furthermore, the approach would almost certainly reduce the treatment costs of glaucoma care.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT04698876, registration date: 11/25/2020.

DRKS-ID: DRKS00023676, registration date: 11/26/2020.

摘要

目的

SALUS 研究旨在改善德国青光眼患者的医疗状况。为了检测日间眼压(IOP)波动,目前的标准是在眼科医院住院监测 IOP 至少 24 小时。SALUS 评估了一种新的门诊护理形式的益处,即患者可以在家中使用自眼压计自行测量 IOP。这种方法应在降低治疗成本的同时,提高患者在医疗体系中的健康能力和赋权感。

方法

SALUS 研究是一项随机对照、开放性非劣效性试验,同时进行经济分析,以确定使用自眼压计进行门诊 IOP 监测是否至少与当前标准护理一样有效,并降低治疗成本。参与者(n=1980)将由德国威斯特伐利亚-利珀地区的当地眼科医生招募,并随机分配接受 7 天门诊或 24 小时住院监测。两组研究参与者还将接受 24 小时血压监测。此外,两组研究参与者的数据将在电子病例档案(ECF)中收集,供医生、医院和研究参与者使用。主要终点是 IOP 峰值患者的百分比,定义为超过患者特定目标压力 30%的水平。数据还将在初始和最终检查期间以及初始检查后 3、6 和 9 个月收集。

结果

研究实施和试验管理情况如下。

结论

SALUS 是一项专注于德国青光眼患者护理的开创性前瞻性临床试验。如果 SALUS 成功,通过引入各种远程医疗组件,可能会改善患者的医疗状况和健康素养。此外,该方法几乎肯定会降低青光眼治疗的成本。

试验注册

ClinicalTrials.gov 标识符:NCT04698876,注册日期:2020 年 11 月 25 日。DRKS-ID:DRKS00023676,注册日期:2020 年 11 月 26 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73fd/9666328/fbcf0bda6c94/417_2022_5759_Fig1_HTML.jpg

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