Bretschneider Maxi Pia, Mayer-Berger Wolfgang, Weine Jens, Roth Lena, Schwarz Peter E H, Petermann Franz
Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, Dresden, 01307, Germany, 49 351 458 2715.
Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, Leichlingen, Germany.
JMIR Cardio. 2024 Dec 11;8:e57960. doi: 10.2196/57960.
Digital interventions are promising additions for both usual care and rehabilitation. Evidence and studies for the latter, however, are still rare.
The aim of the study was to examine the app/web-based patient education program called "mebix" (previously called "Vision 2 - Gesundes Herz") regarding its effectiveness in relation to the parameters of disease-specific quality of life (HeartQoL), cardiovascular risk profile (Cardiovascular Risk Management [CARRISMA]), and prognostic estimation of early retirement (Screening instrument work and occupation [SIBAR]) in 190 participants from a cardiological rehabilitation clinic.
To evaluate mebix, 354 patients from the Roderbirken Clinic of the German Pension Insurance Rhineland (Germany) with a coronary heart diesase were recruited and randomized either to the intervention group (using mebix postrehabiliation for up to 12 months) or the control group (receiving standard care). The data collection took place at the end of inpatient rehabilitation (t0), as well as 6 months (t1) and 12 months (t2) after the end of rehabilitation. Analyses of variance are used to assess the overall significance of difference in outcome parameters between groups and over time.
The primary endpoint of disease-related quality of life shows a significant improvement of 7.35 points over the course of the intervention that is also more pronounced in the intervention group. Similarly, the 10-year risk of cardiovascular death and myocardial infarction showed significant improvements in the cardiovascular risk profile over time and between groups, indicating better results in the intervention group (ie, a reduction of -1.59 and -5.03, respectively). Positive effects on secondary outcomes like body weight, blood pressure, and number of smokers only showed time effects, indicating no difference between the groups. In addition, the SIBAR was significantly lower/better at the end of the observation period than at the beginning of the observation for both groups.
Overall, the digital training program represents an effective follow-up offer after rehabilitation that could be incorporated into standard care to further improve disease-related quality of life and cardiovascular risk profiles.
数字干预有望为常规护理和康复增添助力。然而，针对后者的证据和研究仍然很少。
本研究旨在考察一款名为“mebix”（之前称为“Vision 2 - Gesundes Herz”）的基于应用程序/网络的患者教育项目，该项目针对德国一家心脏康复诊所的190名参与者，在疾病特异性生活质量（HeartQoL）、心血管风险状况（心血管风险管理[CARRISMA]）以及提前退休预后评估（筛查工具工作与职业[SIBAR]）等参数方面的有效性。
为评估mebix，招募了德国莱茵兰德国养老保险罗德比尔肯诊所的354例冠心病患者，并将其随机分为干预组（康复后使用mebix长达12个月）或对照组（接受标准护理）。数据收集在住院康复结束时（t0）以及康复结束后6个月（t1）和12个月（t2）进行。方差分析用于评估组间以及随时间变化的结局参数差异的总体显著性。
疾病相关生活质量的主要终点在干预过程中显著改善了7.35分，且在干预组中更为明显。同样，心血管死亡和心肌梗死的10年风险在心血管风险状况方面随时间推移以及组间均有显著改善，表明干预组效果更好（即分别降低了-1.59和-5.03）。对体重、血压和吸烟人数等次要结局的积极影响仅显示出时间效应，表明两组之间无差异。此外，两组在观察期结束时的SIBAR均显著低于/优于观察期初。
总体而言，该数字培训项目是康复后一种有效的后续服务，可以纳入标准护理，以进一步改善疾病相关生活质量和心血管风险状况。
