有代谢风险因素的患者的人际支持和自助型电子健康生活方式干预的效果：一项荟萃分析。

Effectiveness of Human-Supported and Self-Help eHealth Lifestyle Interventions for Patients With Cardiometabolic Risk Factors: A Meta-Analysis.

机构信息

From the Health, Medical, and Neuropsychology Unit, Institute of Psychology (Cohen Rodrigues, Breeman, Kinik, Reijnders, Janssen, Evers), and Institute of Psychology, Methodology and Statistics Group (Dusseldorp), Leiden University; Department of Cardiology (Janssen, Atsma), Leiden University Medical Center, Leiden; NDDO Institute for Prevention and Early Diagnostics (NIPED) (Kraaijenhagen), Amsterdam; Vital10 (Kraaijenhagen), Amsterdam; Department of Psychiatry (Evers), Leiden University Medical Center, Leiden; and Medical Delta, Leiden University, Technical University of Delft, and Erasmus University Rotterdam (Evers), the Netherlands.

出版信息

Psychosom Med. 2023;85(9):795-804. doi: 10.1097/PSY.0000000000001242. Epub 2023 Oct 9.

DOI:10.1097/PSY.0000000000001242

PMID:37549197

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10662612/

Abstract

OBJECTIVE

eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective.

METHODS

Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique ( N = 20,781) studies were included.

RESULTS

The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes ( p < .001). However, these effects were not moderated by intervention type ( p = .169), dose ( p = .698), or delivery mode of human support ( p = .557).

CONCLUSIONS

This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support.Meta-analysis registration: PROSPERO CRD42021269263 .

摘要

目的

电子健康是为患有心脏代谢疾病的患者提供生活方式干预的有用工具。然而，关于这些电子健康干预措施是否应该得到专业人员的支持，或者自助干预措施是否同样有效，存在不一致的发现。

方法

在 1995 年 1 月至 2021 年 10 月期间，检索了关于心脏代谢疾病（心血管疾病、慢性肾脏病、1 型和 2 型糖尿病）和电子健康生活方式干预的随机对照试验数据库。使用多级荟萃分析来汇总临床和行为健康结果。进行了调节分析，以评估干预类型（自助与人工支持）、人工支持剂量（干预的次要部分与主要部分）和人工支持传递模式（远程与混合）的效果。有 107 篇文章符合入选标准，102 项独特（N=20781）研究被纳入。