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基于家庭的心脏远程康复对心力衰竭患者的有效性:随机对照试验的系统评价和荟萃分析

Effectiveness of home-based cardiac telerehabilitation in patients with heart failure: A systematic review and meta-analysis of randomised controlled trials.

作者信息

Gao Yan, Wang Nan, Zhang Lixin, Liu Naiquan

机构信息

Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China.

Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

J Clin Nurs. 2023 Nov;32(21-22):7661-7676. doi: 10.1111/jocn.16726. Epub 2023 Apr 16.

Abstract

AIMS AND OBJECTIVES

To evaluate the effectiveness of home-based cardiac telerehabilitation in patients with heart failure.

DESIGN

This systematic review and meta-analysis of randomised controlled trials were designed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

METHODS

Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias within the included studies. A fixed- or random-effects meta-analysis model was used to determine the mean difference, based on the results of the heterogeneity test.

DATA SOURCES

A librarian-designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify studies in English or Chinese on randomised controlled trials up to 15 August 2022.

RESULTS

A total of 2291 studies were screened. The meta-analysis included data from 16 studies representing 4557 participants. The results indicated that home-based cardiac telerehabilitation could improve heart rate, VO2 peak, 6-minute walk distance, quality of life and reduce readmission rates. No significant differences were observed in the left ventricular ejection fraction percentages between the home-based cardiac telerehabilitation and usual care groups. Compared with centre-based cardiac rehabilitation, home-based cardiac telerehabilitation showed no significant improvement in outcome indicators.

CONCLUSION

Patients with heart failure benefit from home-based cardiac telerehabilitation intervention. With the rapid development of information and communication technology, home-based cardiac telerehabilitation has great potential and may be used as an adjunct or substitute for centre-based cardiac rehabilitation.

IMPACT

This systematic review and meta-analysis found that patients with heart failure would benefit from home-based cardiac telerehabilitation intervention in terms of cardiac function, functional capacity, quality-of-life management and readmission rate. Future clinical interventions should consider home-based cardiac telerehabilitation as an alternative to conventional cardiac rehabilitation in patients with heart failure to improve their quality of life.

NO PATIENT OR PUBLIC CONTRIBUTION

Our paper is a systematic review and meta-analysis, and such details do not apply to our work.

摘要

目的与目标

评估家庭心脏远程康复对心力衰竭患者的有效性。

设计

本随机对照试验的系统评价和荟萃分析是按照系统评价和荟萃分析的首选报告项目指南设计和报告的。

方法

两名研究人员独立筛选符合条件的研究。使用《Cochrane干预措施系统评价手册》评估纳入研究中的偏倚风险。根据异质性检验结果,使用固定效应或随机效应荟萃分析模型确定平均差异。

数据来源

由图书馆员设计,检索了Cochrane图书馆、PubMed、科学网、EMBASE、CINAHL、中国生物医学文献数据库、中国知网和万方数据库,以识别截至2022年8月15日的英文或中文随机对照试验研究。

结果

共筛选出2291项研究。荟萃分析纳入了16项研究的数据,涉及4557名参与者。结果表明,家庭心脏远程康复可改善心率、峰值摄氧量、6分钟步行距离、生活质量并降低再入院率。家庭心脏远程康复组和常规护理组之间的左心室射血分数百分比未观察到显著差异。与基于中心的心脏康复相比,家庭心脏远程康复在结局指标上未显示出显著改善。

结论

心力衰竭患者可从家庭心脏远程康复干预中获益。随着信息通信技术的快速发展,家庭心脏远程康复具有巨大潜力,可作为基于中心的心脏康复的辅助或替代方法。

影响

本系统评价和荟萃分析发现,心力衰竭患者在心脏功能、功能能力、生活质量管理和再入院率方面将从家庭心脏远程康复干预中获益。未来的临床干预应考虑将家庭心脏远程康复作为心力衰竭患者传统心脏康复的替代方法,以改善他们的生活质量。

无患者或公众参与

我们的论文是一项系统评价和荟萃分析,此类细节不适用于我们的工作。

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