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7至17岁儿童哮喘控制的远程医疗与面对面就诊比较:一项随机对照试验

Comparison of Telemedicine versus In-Person Visit for Control of Asthma in Children aged 7-17 years: A Randomized Controlled Trial.

作者信息

Suvarna Kkomal C, Kumar Prawin, Singh Kuldeep, Kumar Jogender, Goyal Jagdish Prasad

机构信息

Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.

Department of Pediatrics, PGIMER, Chandigarh, India.

出版信息

Indian J Pediatr. 2025 May;92(5):467-473. doi: 10.1007/s12098-024-05028-x. Epub 2024 Feb 13.

Abstract

OBJECTIVES

To compare asthma control between telemedicine and in-person visit in children aged 7 to 17 y.

METHODS

A non-inferiority randomized-controlled trial was conducted at a pediatric chest clinic, involving a total of 192 patients, with 96 children in each group of telemedicine and in-person follow-up.

RESULTS

There was a significant improvement in the mean asthma control test (ACT)/ Childhood asthma control test (C-ACT) scores from baseline to three months in both groups, with no significant difference in the change of means between the two groups. The mean difference in ACT/C-ACT score at three months in the telemedicine and in-person visit group was -0.35; 95% CI (-1.30 to +0.10) [p-value 0.09]. There was a significant change in the mean Pediatric Quality of Life index (PQLI) scores from 57.2 ± 10.2 to 66.82 ± 7.99 in the telemedicine group and from 56.1 ± 11.7 to 66.71 ± 4.66 in the in-person visit group, however the mean difference in PQLI score in both the groups was not significant (p = 0.91). There was no significant difference in the number of asthma exacerbations (4 vs. 1) between telemedicine and in-person visit (p = 0.10). The mean telemedicine satisfaction questionnaire score in this study was 3.8 ± 0.7, which indicates that most of the parents were satisfied with the telemedicine follow-up process.

CONCLUSIONS

This study revealed that telemedicine is non-inferior to in-person visit for follow-up of children with asthma and can be used as an alternative to in-person visit for the management of asthma, especially in remote settings and pandemic situations.

摘要

目的

比较7至17岁儿童远程医疗与面对面就诊时的哮喘控制情况。

方法

在一家儿科胸部诊所进行了一项非劣效性随机对照试验,共纳入192例患者,远程医疗组和面对面随访组各96名儿童。

结果

两组从基线到三个月时,平均哮喘控制测试(ACT)/儿童哮喘控制测试(C-ACT)评分均有显著改善,两组均值变化无显著差异。远程医疗组和面对面就诊组在三个月时ACT/C-ACT评分的平均差值为-0.35;95%置信区间(-1.30至+0.10)[p值0.09]。远程医疗组的平均儿童生活质量指数(PQLI)评分从57.2±10.2显著变化至66.82±7.99,面对面就诊组从56.1±11.7变化至66.71±4.66,但两组PQLI评分的平均差值不显著(p = 0.91)。远程医疗与面对面就诊之间的哮喘加重次数无显著差异(4次对1次)(p = 0.10)。本研究中远程医疗满意度调查问卷的平均评分为3.8±0.7,这表明大多数家长对远程医疗随访过程感到满意。

结论

本研究表明,对于哮喘患儿的随访,远程医疗不劣于面对面就诊,可作为哮喘管理中面对面就诊的替代方式,尤其是在偏远地区和疫情情况下。

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