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电子健康自我管理干预措施对心力衰竭患者的疗效比较:贝叶斯网络荟萃分析。

Comparative effectiveness of ehealth self-management interventions for patients with heart failure: A Bayesian network meta-analysis.

机构信息

Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, PR China.

Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China.

出版信息

Patient Educ Couns. 2024 Jul;124:108277. doi: 10.1016/j.pec.2024.108277. Epub 2024 Mar 28.

Abstract

OBJECTIVE

This study evaluated the effectiveness of electronic self-management support interventions in reducing all-cause mortality, cardiovascular mortality, readmission rates, and HF-related readmission in heart failure patients.

METHODS

Following the PRISMA-P guidelines and PRISMS taxonomy, we searched Pubmed, Cochrane Library, and Embase for RCTs and trials of electronic health technologies for heart failure interventions. Develop support programs in advance for education, monitoring, reminders, or a combination of these to screen and categorize studies. The Cochrane ROB2 tool was used to assess the risk of bias.

RESULTS

The monitoring interventions may improve all-cause mortality (OR 0.77, 95% CI 0.63 to 0.93) and cardiovascular mortality (OR 0.75, 95% CI 0.61 to 0.93) compared to usual care. Reminder interventions were associated with significantly reducing readmission rates (OR 0.07, 95% CI 0.00 to 0.94). Mixed interventions were most effective in reducing HF-related readmission rates (OR 0.75, 95% CI 0.56 to 0.99).

CONCLUSION

Electronic self-management interventions, particularly monitoring and reminders, can potentially improve outcomes of heart failure patients, including reducing all-cause mortality, cardiovascular mortality, and readmission rates.

PRACTICE IMPLICATIONS

The eHealth model and the combination of self-management are significant for long-term intervention in patients with HF to improve their quality of life and prognosis.

摘要

目的

本研究评估了电子自我管理支持干预措施在降低心力衰竭患者全因死亡率、心血管死亡率、再入院率和心力衰竭相关再入院率方面的有效性。

方法

根据 PRISMA-P 指南和 PRISMS 分类法,我们在 Pubmed、Cochrane Library 和 Embase 中搜索了 RCT 和电子健康技术干预心力衰竭的试验。预先制定支持计划,用于教育、监测、提醒或这些方法的组合,以筛选和分类研究。使用 Cochrane ROB2 工具评估偏倚风险。

结果

与常规护理相比,监测干预措施可能改善全因死亡率(OR 0.77,95%CI 0.63 至 0.93)和心血管死亡率(OR 0.75,95%CI 0.61 至 0.93)。提醒干预措施与显著降低再入院率相关(OR 0.07,95%CI 0.00 至 0.94)。混合干预措施在降低心力衰竭相关再入院率方面最有效(OR 0.75,95%CI 0.56 至 0.99)。

结论

电子自我管理干预措施,特别是监测和提醒,可能改善心力衰竭患者的结局,包括降低全因死亡率、心血管死亡率和再入院率。

实践意义

电子健康模型和自我管理的结合对改善 HF 患者的生活质量和预后具有重要意义。

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