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基于可穿戴设备的远程医疗管理对老年慢性冠心病患者心血管结局的多参数监测:一项开放标签、随机对照试验。

Wearable equipment-based telemedical management via multiparameter monitoring on cardiovascular outcomes in elderly patients with chronic coronary heart disease: an open-labelled, randomised, controlled trial.

作者信息

Lu Tingting, Cao Ruihua, Wang Yujia, Kong Xiaoxuan, Wang Huiquan, Sun Guanghua, Gao Shan, Wang Yabin, Yuan Yuan, Shen Xiaoying, Fan Li, Ren Jun, Cao Feng

机构信息

School of Medicine, Nankai University, Tianjin, China.

Department of Cardiology, The Second Medical Center of Chinese PLA General Hospital & National Clinical Research Center for Geriatric Diseases, Beijing, China.

出版信息

BMJ Health Care Inform. 2024 Dec 10;31(1):e101135. doi: 10.1136/bmjhci-2024-101135.

DOI:10.1136/bmjhci-2024-101135
PMID:39674587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11647296/
Abstract

BACKGROUND

The prevalence of chronic coronary heart diseases (CHDs) increases with age in the elderly, which represents one of the top-ranked causes of death and disease burden.

METHODS

This study aimed to investigate the management efficiency of telemedicine based on the remote multiparameter monitoring in elderly patients with CHD. A total of 1248 elderly patients diagnosed with CHD were enrolled. The subjects were randomly divided into two groups, wearable equipment-based telemedical management (WTM) group and traditional follow-up management (TFM) group. Face-to-face clinical interview at least once every 2 months was required in TFM group to collect the medical records. Patients in WTM group were provided with wearable equipment to complete remote monitoring, real-time alerts and health intervention via virtual consultations and remote medication recommendations.

RESULTS

The mean age of patients in WTM group and TFM group was 71.1 (68.0-82.0) years and 71.0 (68.0-81.0) years, respectively‏. After a 12-month management, patients in WTM group presented a lower occurrence of hospitalisation (HR 0.59, 95% CI=0.47 to 0.73, p<0.0001) and major adverse cardiac events (HR 0.60, 95% CI=0.44 to 0.82, p=0.0012) compared with patients in TFM group.

CONCLUSION

The multiparameter telemedical management could help with the out-of-hospital management and reduce the incidence of rehospitalisation in elderly patients with CHD.

摘要

背景

老年人群中慢性冠心病(CHD)的患病率随年龄增长而增加,这是导致死亡和疾病负担的主要原因之一。

方法

本研究旨在探讨基于远程多参数监测的远程医疗对老年冠心病患者的管理效果。共纳入1248例确诊为冠心病的老年患者。将受试者随机分为两组,即基于可穿戴设备的远程医疗管理(WTM)组和传统随访管理(TFM)组。TFM组要求每2个月至少进行一次面对面临床访谈以收集病历。WTM组患者配备可穿戴设备,通过虚拟会诊和远程用药建议完成远程监测、实时警报和健康干预。

结果

WTM组和TFM组患者的平均年龄分别为71.1(68.0 - 82.0)岁和71.0(68.0 - 81.0)岁。经过12个月的管理,与TFM组患者相比,WTM组患者的住院率(HR 0.59,95%CI = 0.47至0.73,p < 0.0001)和主要不良心脏事件发生率(HR 0.60,95%CI = 0.44至0.82,p = 0.0012)更低。

结论

多参数远程医疗管理有助于老年冠心病患者的院外管理,并降低再住院率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/f7db96f3ba99/bmjhci-31-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/5e721a2155f1/bmjhci-31-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/4119ace1e1a7/bmjhci-31-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/29ef9c753252/bmjhci-31-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/f7db96f3ba99/bmjhci-31-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/5e721a2155f1/bmjhci-31-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/4119ace1e1a7/bmjhci-31-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/29ef9c753252/bmjhci-31-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526e/11647296/f7db96f3ba99/bmjhci-31-1-g004.jpg

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