25 年来移动医疗工具在慢性肌肉骨骼疼痛患者疼痛管理中的影响：系统评价。

Impact of 25 Years of Mobile Health Tools for Pain Management in Patients With Chronic Musculoskeletal Pain: Systematic Review.

机构信息

Department of Medicine, Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

J Med Internet Res. 2024 Aug 16;26:e59358. doi: 10.2196/59358.

DOI:10.2196/59358

PMID:39150748

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11364951/

Abstract

BACKGROUND

Mobile technologies are increasingly being used in health care and public health practice for patient communication, monitoring, and education. Mobile health (mHealth) tools have also been used to facilitate adherence to chronic musculoskeletal pain (CMP) management, which is critical to achieving improved pain outcomes, quality of life, and cost-effective health care.

OBJECTIVE

The aim of this systematic review was to evaluate the 25-year trend of the literature on the adherence, usability, feasibility, and acceptability of mHealth interventions in CMP management among patients and health care providers.

METHODS

We searched the PubMed, Cochrane CENTRAL, MEDLINE, EMBASE, and Web of Science databases for studies assessing the role of mHealth in CMP management from January 1999 to December 2023. Outcomes of interest included the effect of mHealth interventions on patient adherence; pain-specific clinical outcomes after the intervention; and the usability, feasibility, and acceptability of mHealth tools and platforms in chronic pain management among target end users.

RESULTS

A total of 89 articles (26,429 participants) were included in the systematic review. Mobile apps were the most commonly used mHealth tools (78/89, 88%) among the included studies, followed by mobile app plus monitor (5/89, 6%), mobile app plus wearable sensor (4/89, 4%), and web-based mobile app plus monitor (1/89, 1%). Usability, feasibility, and acceptability or patient preferences for mHealth interventions were assessed in 26% (23/89) of the studies and observed to be generally high. Overall, 30% (27/89) of the studies used a randomized controlled trial (RCT), cohort, or pilot design to assess the impact of the mHealth intervention on patients' adherence, with significant improvements (all P<.05) observed in 93% (25/27) of these studies. Significant (judged at P<.05) between-group differences were reported in 27 of the 29 (93%) RCTs that measured the effect of mHealth on CMP-specific clinical outcomes.

CONCLUSIONS

There is great potential for mHealth tools to better facilitate adherence to CMP management, and the current evidence supporting their effectiveness is generally high. Further research should focus on the cost-effectiveness of mHealth interventions for better incorporating these tools into health care practices.

TRIAL REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO) CRD42024524634; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=524634.

摘要

背景

移动技术在医患沟通、监测和教育方面在医疗保健和公共卫生实践中得到了越来越多的应用。移动医疗（mHealth）工具也被用于促进慢性肌肉骨骼疼痛（CMP）管理的依从性，这对于改善疼痛结局、生活质量和具有成本效益的医疗保健至关重要。

目的

本系统评价旨在评估 25 年来关于 mHealth 干预措施在 CMP 管理中对患者和医疗保健提供者的依从性、可用性、可行性和可接受性的文献趋势。

方法

我们检索了 PubMed、Cochrane CENTRAL、MEDLINE、EMBASE 和 Web of Science 数据库，以评估 1999 年 1 月至 2023 年 12 月期间 mHealth 在 CMP 管理中的作用的研究。感兴趣的结果包括 mHealth 干预措施对患者依从性的影响；干预后疼痛特异性临床结局；以及目标终端用户在慢性疼痛管理中使用 mHealth 工具和平台的可用性、可行性和可接受性。

结果

系统评价共纳入 89 篇文章（26429 名参与者）。移动应用程序是纳入研究中最常用的 mHealth 工具（78/89，88%），其次是移动应用程序加监测器（5/89，6%）、移动应用程序加可穿戴传感器（4/89，4%）和基于网络的移动应用程序加监测器（1/89，1%）。26%（23/89）的研究评估了 mHealth 干预措施的可用性、可行性和可接受性或患者偏好，总体上观察到较高的可用性、可行性和可接受性或患者偏好。总体而言，30%（27/89）的研究使用随机对照试验（RCT）、队列或试点设计来评估 mHealth 干预对患者依从性的影响，其中 93%（25/27）的研究观察到显著改善（均 P<.05）。27 项 RCT 中有 27 项（93%）报告了 mHealth 对 CMP 特定临床结局影响的组间显著差异（P<.05）。