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心力衰竭远程监测的使用模式:e-Vita心力衰竭试验的事后分析

Patterns in the Use of Heart Failure Telemonitoring: Post Hoc Analysis of the e-Vita Heart Failure Trial.

作者信息

Brons Maaike, Ten Klooster Iris, van Gemert-Pijnen Lisette, Jaarsma Tiny, Asselbergs Folkert W, Oerlemans Marish I F J, Koudstaal Stefan, Rutten Frans H

机构信息

Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands.

Department of Psychology, Health and Technology, Center for eHealth Research and Disease Management, University of Twente, Enschede, Netherlands.

出版信息

JMIR Cardio. 2023 Jan 31;7:e41248. doi: 10.2196/41248.

Abstract

BACKGROUND

Research on the use of home telemonitoring data and adherence to it can provide new insights into telemonitoring for the daily management of patients with heart failure (HF).

OBJECTIVE

We described the use of a telemonitoring platform-including remote patient monitoring of blood pressure, pulse, and weight-and the use of the electronic personal health record. Patient characteristics were assessed in both adherent and nonadherent patients to weight transmissions.

METHODS

We used the data of the e-Vita HF study, a 3-arm parallel randomized trial performed in stable patients with HF managed in outpatient clinics in the Netherlands. In this study, data were analyzed from the participants in the intervention arm (ie, e-Vita HF platform). Adherence to weight transmissions was defined as transmitting weight ≥3 times per week for at least 42 weeks during a year.

RESULTS

Data from 150 patients (mean age 67, SD 11 years; n=37, 25% female; n=123, 82% self-assessed New York Heart Association class I-II) were analyzed. One-year adherence to weight transmissions was 74% (n=111). Patients adherent to weight transmissions were less often hospitalized for HF in the 6 months before enrollment in the study compared to those who were nonadherent (n=9, 8% vs n=9, 23%; P=.02). The percentage of patients visiting the personal health record dropped steadily over time (n=140, 93% vs n=59, 39% at one year). With univariable analyses, there was no significant correlation between patient characteristics and adherence to weight transmissions.

CONCLUSIONS

Adherence to remote patient monitoring was high among stable patients with HF and best for weighing; however, adherence decreased over time. Clinical and demographic variables seem not related to adherence to transmitting weight.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01755988; https://clinicaltrials.gov/ct2/show/NCT01755988.

摘要

背景

关于家庭远程监测数据的使用及其依从性的研究可为心力衰竭(HF)患者的日常管理中的远程监测提供新见解。

目的

我们描述了一个远程监测平台的使用,包括对患者血压、脉搏和体重的远程监测,以及电子个人健康记录的使用。对体重传输依从和不依从的患者的特征进行了评估。

方法

我们使用了e-Vita HF研究的数据,这是一项在荷兰门诊管理的稳定HF患者中进行的三臂平行随机试验。在本研究中,对干预组(即e-Vita HF平台)的参与者数据进行了分析。体重传输的依从性定义为在一年中每周传输体重≥3次,持续至少42周。

结果

分析了150例患者的数据(平均年龄67岁,标准差11岁;n = 37,25%为女性;n = 123,82%自我评估为纽约心脏协会I-II级)。体重传输的一年依从率为74%(n = 111)。与不依从的患者相比,在研究入组前6个月,依从体重传输的患者因HF住院的频率较低(n = 9,8%对n = 9,23%;P = 0.02)。随着时间的推移,访问个人健康记录的患者百分比稳步下降(一年时n = 140,93%对n = 59,39%)。单变量分析显示,患者特征与体重传输依从性之间无显著相关性。

结论

稳定的HF患者对远程患者监测的依从性较高,对体重监测最佳;然而,依从性随时间下降。临床和人口统计学变量似乎与体重传输的依从性无关。

试验注册

ClinicalTrials.gov NCT01755988;https://clinicaltrials.gov/ct2/show/NCT01755988

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3047/9929726/fddf56e39dfc/cardio_v7i1e41248_fig1.jpg

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