远程医疗试验解决卒中幸存者中的健康公平问题。
Telehealth Trials to Address Health Equity in Stroke Survivors.
机构信息
Department of Neurology, McGovern Medical School, University of Texas Health Sciences Center at Houston (A.Z.S., M.O.).
McGovern Medical School, Stroke Institute, University of Texas Health Sciences Center (A.Z.S.).
出版信息
Stroke. 2023 Feb;54(2):396-406. doi: 10.1161/STROKEAHA.122.039566. Epub 2023 Jan 23.
Abstract
Telehealth has seen rapid expansion into chronic care management in the past 3 years because of the COVID-19 pandemic. Telehealth for acute care management has expanded access to equitable stroke care to many patients over the past two decades, but there is limited evidence for its benefit for addressing disparities in the chronic care of patients living with stroke. In this review, we discuss advantages and disadvantages of telehealth use for the outpatient management of stroke survivors. Further, we explore opportunities and potential barriers for telehealth in addressing disparities in stroke outcomes related to various social determinants of health. We discuss two ongoing large randomized trials that are utilizing telehealth and telemonitoring for management of blood pressure in diverse patient populations. Finally, we discuss strategies to address barriers to telehealth use in patients with stroke and in populations with adverse social determinants of health.
摘要
在过去的三年中，由于 COVID-19 大流行，远程医疗在慢性病管理领域迅速扩张。在过去的二十年中，远程医疗在急性疾病管理方面扩大了对许多患者公平的卒中护理的可及性，但对于其在解决慢性病患者护理方面的差异方面的益处的证据有限。在这篇综述中，我们讨论了远程医疗在门诊管理中风幸存者方面的优缺点。此外，我们探讨了远程医疗在解决与各种健康社会决定因素相关的中风结局差异方面的机会和潜在障碍。我们讨论了两项正在进行的大型随机试验，这些试验正在利用远程医疗和远程监测来管理不同患者群体的血压。最后，我们讨论了在有中风和有不利健康社会决定因素的人群中解决远程医疗使用障碍的策略。
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2
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Appl Clin Inform. 2022 Oct;13(5):1053-1062. doi: 10.1055/a-1951-3153. Epub 2022 Sep 27.
3
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