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冠心病患者的治疗教育:数字平台监测对预防突尼斯主要心血管事件的影响:研究方案。

Therapeutic education of patients with coronary heart disease: Impact of digital platform monitoring in preventing major cardiovascular events in Tunisia: Study protocol.

机构信息

Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.

Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia.

出版信息

PLoS One. 2024 Apr 18;19(4):e0300250. doi: 10.1371/journal.pone.0300250. eCollection 2024.

Abstract

BACKGROUND

Faced with the increase in the number of chronic diseases with the aging of the population, and with the observation of the insufficiency of therapeutic control, a new need has emerged, that of having a patient as a partner in care.

METHODS

This study is a randomized controlled trial. Patients with coronary heart disease will be recruited from one clinical site and randomly assigned into two groups: the intervention group and the control group. All participants will be followed up for a total of one year (with three-time points for data collection). Patients who are assigned to the intervention group will receive therapeutic education at first. The digital platform will then allow healthcare providers to accompany them outside the hospital walls. The primary outcome is the incidence of major cardiovascular events within one year of discharge. Main secondary outcomes include changes in health behaviors, medication adherence, and quality of life score. The digital platform is a multi-professional telemonitoring platform that allows care teams to accompany the patient outside the hospital walls. It allows the collection and transmits information from the patient's home to the therapeutic education team. All data will be secured at a certified host. The patient application provides data on compliance, adherence to physical activity (number of steps taken per day), adequate diet (weight gain, food consumed during the meal, compliance with low-salt or salt-free diet, diabetic diet), smoking cessation, as well as medication adherence. Access to educational tools (digital media) is provided to all initial program participants. These tools will be updated annually by the rehabilitation team on the recommendations. The platform also offers the possibility of organizing an individual or group remote educational session (videoconference modules allowing group and individual sessions), a secure integrated caregiver-patient messaging system. The control group will receive the usual controls at the hospital.

DISCUSSION

To offer a complete solution of care to our patients, we have thought of setting up a digital platform that aims to monitor the patient and strengthen their abilities to manage their condition daily. This pilot experience could be generalized to several services and disciplines. It could be used in several research works.

TRIAL REGISTRATION

Trial registered with the Pan African Clinical Trial Registry (PACTR202307694422939). URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24247.

摘要

背景

随着人口老龄化导致慢性病患者数量的增加,以及观察到治疗控制的不足,出现了一种新的需求,即让患者成为护理的合作伙伴。

方法

本研究为一项随机对照试验。将从一个临床站点招募冠心病患者,并将其随机分为两组:干预组和对照组。所有参与者将在一年内(共进行三次数据收集)进行随访。被分配到干预组的患者将首先接受治疗教育。然后,数字平台将允许医疗保健提供者在医院墙外陪伴他们。主要结局是出院后一年内主要心血管事件的发生率。主要次要结局包括健康行为、药物依从性和生活质量评分的变化。数字平台是一个多专业远程监测平台,允许护理团队在医院墙外陪伴患者。它允许从患者家中收集并传输信息到治疗教育团队。所有数据都将在经过认证的主机上进行安全保护。患者应用程序提供了关于依从性、身体活动(每天走的步数)、适当饮食(体重增加、用餐时摄入的食物、低盐或无盐饮食、糖尿病饮食的依从性)、戒烟以及药物依从性的数据。所有初始项目参与者都可以访问教育工具(数字媒体)。康复团队将根据建议每年更新这些工具。该平台还提供了组织个人或小组远程教育课程(视频会议模块允许小组和个人课程)的可能性,以及一个安全的综合护理人员-患者消息系统。对照组将在医院接受常规治疗。

讨论

为了为我们的患者提供完整的护理解决方案,我们想到了建立一个数字平台,旨在监测患者并增强他们日常管理病情的能力。这种试点经验可以推广到几个服务和学科。它可以用于几个研究工作。

试验注册

试验在泛非临床试验注册处(PACTR202307694422939)注册。网址:https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24247。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cb9/11025886/dccd36e11604/pone.0300250.g001.jpg

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