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治疗依从性对数字治疗运动计划有效性的影响:倾向得分匹配分析

The Effect of Therapeutic Adherence on the Effectiveness of a Digital Therapeutic Exercise Program: A Propensity Score Matching Analysis.

作者信息

Klingenberg Markus, Elsner Andreas, Pooth Jan-Steffen, Hans Felix Patricius, Benning Leo

机构信息

Beta Klinik, 53227 Bonn, Germany.

German Institute of Orthopedics Osteopathy and Sports Medicine, 33604 Bielefeld, Germany.

出版信息

Healthcare (Basel). 2023 Sep 23;11(19):2614. doi: 10.3390/healthcare11192614.

Abstract

UNLABELLED

Nonspecific back pain (NSBP) contributes greatly to the overall burden of disease from musculoskeletal conditions. Digital therapeutics (DTx) aims to address the excess demand for movement and exercise therapy resulting from this spectrum of conditions. This study aims to investigate the differential therapeutic response of NSBP to different use profiles of a digital home exercise program.

METHODS

This study used a PSM model to comparatively assess the achievement of a clinically relevant pain improvement among patients who exhibit a high use (HU), intermediate use (IU), low use (LU), or sub-LU use profile. Sensitivity analyses with commonly accepted thresholds for clinically relevant improvements were conducted.

RESULTS

Higher use profiles show a higher probability of achieving a clinically relevant improvement of self-reported pain intensities. Additionally, the achievement of any higher use level is associated with a significant increase in the probability of achieving a clinically relevant improvement.

CONCLUSION

To enable the optimal effectiveness of DTx home exercise programs, an HU use profile should be pursued. This finding is in line with earlier guidance for the achievement of optimal therapeutic benefit from conventional movement and exercise therapy and underscores the importance of a cross-disciplinary effort from patients, healthcare professionals and system stakeholders alike to maximize the therapeutic effect from DTx.

摘要

未标注

非特异性背痛(NSBP)在肌肉骨骼疾病导致的整体疾病负担中占比很大。数字疗法(DTx)旨在解决因这类疾病而产生的对运动和锻炼疗法的过度需求。本研究旨在调查NSBP对数字家庭锻炼计划不同使用模式的差异治疗反应。

方法

本研究使用倾向评分匹配(PSM)模型,比较评估表现出高使用(HU)、中等使用(IU)、低使用(LU)或超低使用(sub-LU)模式的患者在临床上实现相关疼痛改善的情况。采用临床相关改善的公认阈值进行敏感性分析。

结果

较高的使用模式显示自我报告疼痛强度在临床上实现相关改善的可能性更高。此外,达到任何更高的使用水平都与临床上实现相关改善的概率显著增加相关。

结论

为使DTx家庭锻炼计划达到最佳效果,应追求HU使用模式。这一发现与早期关于从传统运动和锻炼疗法中获得最佳治疗益处的指导意见一致,并强调了患者、医疗保健专业人员和系统利益相关者等跨学科努力对于最大化DTx治疗效果的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0584/10572588/6b145c31ce07/healthcare-11-02614-g001.jpg

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