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移动解决方案与慢性病:移动应用程序和数字平台的开发与实施,用于收集、分析数据、监测和管理医疗保健。

Mobile solution and chronic diseases: development and implementation of a mobile application and digital platform for collecting, analyzing data, monitoring and managing health care.

机构信息

Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG, Brazil.

Computing Department, Federal University of Tocantins, Palmas, Tocantins, Brazil.

出版信息

BMC Health Serv Res. 2024 Aug 31;24(1):1009. doi: 10.1186/s12913-024-11505-y.

Abstract

BACKGROUND

Technological advances based on mobile health (mHealth), the field of digital health (eHealth) aimed at managing health services and care and their concomitant transformations, have become increasingly important in the 21st century. In this context, care for individuals diagnosed with Chronic Non-Communicable Diseases (CNCDs) deserves to be highlighted. The aim of this study is to present the creation, development and implementation of the Telehealth Center of the Federal University of Viçosa (NUTELES - UFV), for the monitoring and management of health care for individuals with Arterial Hypertension (AH) and/or Diabetes Mellitus (DM).

METHODS

This study, carried out in 2022 and 2023, involved 374 patients diagnosed with AH and/or DM in the health micro-region of Viçosa/MG, Brazil, comprising nine municipalities. The research aims to describe the creation, development and implementation of a software (NutelesApp) for the collection, storage, management and analysis of epidemiological research in public health, focusing specifically, on the monitoring and management of health care for individuals with AH and/or DM monitored by Primary Health Care (PHC). The parameters collected and analyzed were obtained through a questionnaire applied to patients, consisting of 70 questions, subdivided into 12 classes of questions. The epidemiological survey data was collected using mobile devices and analyzed using computer techniques based on statistical analysis. Once the field teams had completed their work, the files were transferred to servers for general analysis processing, using estimates of means, prevalence and respective standard errors, calculated using the Statistical Package for Social Science (SPSS) program, which takes into account the planning variables and includes the basic weights resulting from the sampling process. This study was approved by the Human Research Ethics Committee and registered, prior to recruitment, by the Brazilian Registry of Clinical Trials (ReBEC), ID: RBR-45hqzmf (Last approval date: 11/30/2022).

RESULTS

The information obtained through data collection with subsequent exploratory analysis of epidemiological data using the NutelesApp software suggests that mobile applications intended for the purpose of monitoring and managing healthcare for people with AH and/or DM should address the variables necessary to support a process of understanding the health conditions and/or disease of the individual as a whole and provide short- and long-term learning. Regarding the results of the survey using the software, the variables of 374 people were analyzed. Majority are female (73.2%) and white (43.5%). Most patients are elderly (average 64 years), with blood pressure levels within the normal range for this population, BMI indicates overweight, AC increased risk for cardiovascular events and CC within the recommendation value. All biochemical parameters analyzed were above normal limits.

CONCLUSIONS

The description of the creation and development of the software includes practical examples of its implementation, the results collected and its applicability in real scenarios, presenting determining criteria that can provide assertive and timely interventions for monitoring and managing the health and/or disease parameters of patients with HA and/or DM. In addition, the beneficial consequences of using this application will extend to health units and their respective management, improving the services provided by PHC and enhancing strategies and actions for health promotion and disease prevention.

摘要

背景

基于移动健康(mHealth)的技术进步,即数字健康(eHealth)领域,旨在管理卫生服务和护理及其伴随的转变,在 21 世纪变得越来越重要。在这种情况下,对诊断患有慢性非传染性疾病(CNCDs)的个体的护理值得强调。本研究旨在展示联邦大学维索萨(UFV)远程医疗中心的创建、发展和实施,用于监测和管理患有高血压(AH)和/或糖尿病(DM)的个体的医疗保健。

方法

本研究于 2022 年至 2023 年期间在巴西米纳斯吉拉斯州维索萨/米纳斯吉拉斯州的卫生微地区进行,涉及 374 名被诊断患有 AH 和/或 DM 的患者,该地区由九个市组成。该研究旨在描述一个软件(NutelesApp)的创建、开发和实施,用于收集、存储、管理和分析公共卫生中的流行病学研究,特别是监测和管理由初级保健(PHC)监测的患有 AH 和/或 DM 的个体的医疗保健。收集和分析的参数是通过应用于患者的问卷获得的,问卷由 70 个问题组成,分为 12 个问题类别。使用移动设备收集流行病学调查数据,并使用基于统计分析的计算机技术进行分析。一旦现场团队完成工作,文件就会被转移到服务器进行一般分析处理,使用均值、患病率和各自的标准误差进行估计,这些估计值使用社会科学统计软件包(SPSS)计算得出,该软件包考虑了规划变量,并包含了抽样过程产生的基本权重。本研究得到了人类研究伦理委员会的批准,并在招募前通过巴西临床试验注册处(ReBEC)进行了注册,注册号为:RBR-45hqzmf(最近批准日期:2022 年 11 月 30 日)。

结果

通过使用 NutelesApp 软件进行数据收集和随后对流行病学数据进行探索性分析获得的信息表明,旨在监测和管理患有 AH 和/或 DM 的人医疗保健的移动应用程序应解决支持理解个体健康状况和/或疾病的整体情况的必要变量,并提供短期和长期的学习。关于使用该软件进行的调查结果,分析了 374 人的变量。大多数是女性(73.2%)和白人(43.5%)。大多数患者年龄较大(平均 64 岁),血压水平在该人群的正常范围内,BMI 表示超重,AC 增加心血管事件风险,CC 在推荐值范围内。所有分析的生化参数均高于正常值。

结论

软件创建和开发的描述包括其实施的实际示例,收集的结果及其在真实场景中的适用性,提出了确定标准,可以为监测和管理患有 HA 和/或 DM 的患者的健康和/或疾病参数提供果断和及时的干预措施。此外,使用该应用程序的有益后果将扩展到卫生单位及其各自的管理,改善初级保健提供的服务,并加强促进健康和预防疾病的战略和行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ef/11365159/38e23ea28851/12913_2024_11505_Fig1_HTML.jpg

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