MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London, United Kingdom; The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe.
The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom; Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany.
Int J Nurs Stud. 2024 Dec;160:104903. doi: 10.1016/j.ijnurstu.2024.104903. Epub 2024 Sep 7.
To systematically review literature from randomised controlled trials (RCTs) investigating the effectiveness of electronic monitoring device informed interventions on adherence and clinical outcomes in children and adolescents with chronic conditions.
A systematic review was conducted. An electronic literature search covering studies, with no pre-specified starting date up to June 2024, was performed in Medline, EMBASE, Web of Science, Cochrane and Trials databases was conducted.
RCTs of electronic monitoring device informed interventions in individuals aged 0 to 18 years with chronic conditions, were identified, with no restriction on geography or publication date.
Extracted data was synthesised. As a result of differences in definitions and analysis of adherence and clinical outcomes across the studies a pooled meta-analysis was not possible therefore, a descriptive analysis was conducted. Risk of bias across all studies was assessed using the Cochrane Collaboration risk of bias tool.
11 RCTs, with 1485 children and adolescents were included. Studies were all from high- and middle-income countries, conducted among children and adolescents with asthma, and one each among children and adolescents with kidney transplant, multiple sclerosis, and epilepsy. Eight of the 11 studies reported a positive effect on adherence. Only four studies reported a positive effect on clinical outcomes and seven studies found no effect on clinical outcomes.
Electronic monitoring device interventions show promise in improving adherence in children and adolescents with chronic conditions, in a limited number of chronic conditions, mostly asthma. Evidence for the efficacy of electronic monitoring device informed interventions on clinical outcomes and from low-income settings is lacking.
PROSPERO, CRD42022312057, registered in March 2022.
Electronic monitoring device informed interventions may improve treatment adherence in children and adolescents with chronic conditions but evidence from low-income settings is lacking @nyasha_dzavakwa @KatharinaKranz4 @dopapus @hilda_mujuru @rashida_abbferr @vickysimms_epi.
系统综述随机对照试验（RCTs）的文献，以评估电子监测设备干预措施对患有慢性病的儿童和青少年的依从性和临床结局的有效性。
进行了系统综述。对截至 2024 年 6 月的 Medline、EMBASE、Web of Science、Cochrane 和 Trials 数据库中的研究进行了电子文献检索，无预先设定的起始日期。
确定了年龄在 0 至 18 岁患有慢性病的个体接受电子监测设备干预的 RCT，对地理位置和出版日期无限制。
提取的数据进行了综合分析。由于研究之间在依从性和临床结局的定义和分析上存在差异，因此无法进行汇总荟萃分析，因此进行了描述性分析。使用 Cochrane 协作风险偏倚工具评估所有研究的偏倚风险。
纳入了 11 项 RCT，共 1485 名儿童和青少年。这些研究均来自高收入和中等收入国家，研究对象为哮喘患儿，另有一项研究对象为肾移植、多发性硬化症和癫痫患儿。其中 8 项研究报告电子监测设备干预对依从性有积极影响。仅有 4 项研究报告电子监测设备干预对临床结局有积极影响，7 项研究未发现对临床结局有影响。
电子监测设备干预措施在改善患有慢性病的儿童和青少年的依从性方面显示出一定的前景，但在少数几种慢性病中，主要是哮喘方面。缺乏来自低收入环境的关于电子监测设备干预措施对临床结局的疗效的证据。
PROSPERO，CRD42022312057，于 2022 年 3 月注册。
电子监测设备干预措施可能会提高慢性病儿童和青少年的治疗依从性，但缺乏来自低收入国家的证据。@nyasha_dzavakwa @KatharinaKranz4 @dopapus @hilda_mujuru @rashida_abbferr @vickysimms_epi。
