用于心脏康复的虚拟医疗保健解决方案:文献综述
Virtual healthcare solutions for cardiac rehabilitation: a literature review.
作者信息
Lee Keni C S, Breznen Boris, Ukhova Anastasia, Koehler Friedrich, Martin Seth S
机构信息
Sanofi, General Medicines Global Business Unit, Paris 75008, France.
Evidinno Outcomes Research Inc., Vancouver, BC V5Y1K2, Canada.
出版信息
Eur Heart J Digit Health. 2023 Feb 9;4(2):99-111. doi: 10.1093/ehjdh/ztad005. eCollection 2023 Mar.
Graphical AbstractAdherence to cardiac rehabilitation following a primary event has been demonstrated to improve quality of life, increase functional capacity, and decrease hospitalizations and mortality. Mobile technologies offer an opportunity to improve both the quality and utilization of cardiac rehabilitation, and recent clinical studies investigated this technology. This literature review summarizes the current use of mobile health, wearable activity monitors (WAMs), and other multi-component technologies deployed to support home-based virtual cardiac rehabilitation. The methodology was adapted from the . We identified 2094 records, of which 113 were eligible for qualitative analysis. Different virtual cardiac rehabilitation solutions were implemented in the studies: (i) multi-component interventions in 48 studies (42.5%), (ii) WAMs in 27 studies (23.9%), (iii) web-based communications solutions, and (iv) mobile apps, both in 19 studies (16.4%). Functional capacity was the most frequently reported primary outcome ( = 37, 32.7%), followed by user adherence/compliance ( = 35, 31.0%), physical activity ( = 27, 23.9%), and quality of life ( = 14, 12.4%). Studies provided a mixed assessment of the efficacy of virtual cardiac rehabilitation in attaining either significant improvements over baseline or significant improvements in outcomes compared with conventional rehabilitation. Efficacy outcomes with virtual cardiac rehabilitation sometimes improve on the centre-based outcomes; however, superior clinical efficacy may not necessarily be the only outcome of interest. The promise of virtual cardiac rehabilitation includes the potential for increased user adherence and longer-term patient engagement. If these outcomes can be improved, that would be a significant justification for using this technology.
图形摘要
已证明在初次事件后坚持心脏康复可改善生活质量、提高功能能力,并减少住院次数和死亡率。移动技术为改善心脏康复的质量和利用率提供了契机,近期的临床研究对该技术进行了调查。本综述总结了移动健康、可穿戴活动监测器(WAM)以及其他为支持家庭虚拟心脏康复而部署的多组件技术的当前应用情况。该方法改编自……我们共识别出2094条记录,其中113条符合定性分析的条件。研究中实施了不同的虚拟心脏康复解决方案:(i)48项研究(42.5%)采用了多组件干预措施,(ii)27项研究(23.9%)使用了WAM,(iii)19项研究(16.4%)采用了基于网络的通信解决方案,以及(iv)19项研究(16.4%)使用了移动应用程序。功能能力是最常报告的主要结局(n = 37,32.7%),其次是用户依从性/顺从性(n = 35,31.0%)、身体活动(n = 27,23.9%)和生活质量(n = 14,12.4%)。研究对虚拟心脏康复在相对于基线取得显著改善或与传统康复相比在结局方面取得显著改善的疗效给出了混合评价。虚拟心脏康复的疗效结果有时优于基于中心的结果;然而,卓越的临床疗效不一定是唯一值得关注的结果。虚拟心脏康复的前景包括提高用户依从性和患者长期参与度的潜力。如果这些结果能够得到改善,那么这将是使用该技术的一个重要理由。