Xia Chengyu, Zheng Yingjun, Ji Liuxia, Liu Hui
The Second Affiliated Hospital of Shantou University Medical College, Building 69, Dongxia North Road, Shantou, Guangdong Province, 515000, China.
Shantou University Medical College, Shantou, Guangdong Province, China.
BMC Nurs. 2024 Dec 18;23(1):897. doi: 10.1186/s12912-024-02561-0.
Exercise-based phase II cardiac rehabilitation is critical for post-PCI patients, but adherence to exercise-based phase II cardiac rehabilitation remains low. Many studies aimed at improving adherence have been conducted in recent years, but the most effective interventions remain unclear. Hence, the objective of this study was to evaluate the effectiveness and ranks of various interventions in enhancing adherence to exercise-based phase II cardiac rehabilitation for post-PCI patients.
A network meta-analysis employing random effects was utilized to evaluate the effectiveness of different interventions. Bias evaluation was performed via the revised Cochrane risk of bias tool, with data analysis performed using STATA v15.0. The surface under the cumulative ranking was used to estimate the rankings among different interventions.
In the final analysis, 30 RCTs with 4267 patients across 17 different interventions were included. The results showed that patients who received home-based cardiac rehabilitation combined with mobile health intervention had the best adherence to exercise-based phase II cardiac rehabilitation (83.8%), followed by hospital-based cardiac rehabilitation combined with mobile health intervention (79.9%).
This network meta-analysis identified home-based CR + mobile health intervention and hospital-based CR + mobile health intervention as the top two ranked interventions for improving adherence to exercise-based phase II CR in post-PCI patients. Healthcare providers may consider prioritizing the use of home-based cardiac rehabilitation combined with mobile health intervention in clinical practice, but still need to evaluate factors such as patient preference and Medicare reimbursement availability to develop customized interventions that are not only safe and effective but also satisfying to the patient.
基于运动的二期心脏康复对PCI术后患者至关重要，但基于运动的二期心脏康复的依从性仍然很低。近年来开展了许多旨在提高依从性的研究，但最有效的干预措施仍不明确。因此，本研究的目的是评估各种干预措施在提高PCI术后患者对基于运动的二期心脏康复的依从性方面的有效性和排名。
采用随机效应的网络荟萃分析来评估不同干预措施的有效性。通过修订的Cochrane偏倚风险工具进行偏倚评估，使用STATA v15.0进行数据分析。累积排名曲线下面积用于估计不同干预措施之间的排名。
在最终分析中，纳入了30项随机对照试验，涉及17种不同干预措施的4267例患者。结果显示，接受家庭心脏康复联合移动健康干预的患者对基于运动的二期心脏康复的依从性最佳（83.8%），其次是医院心脏康复联合移动健康干预（79.9%）。
这项网络荟萃分析确定家庭心脏康复+移动健康干预和医院心脏康复+移动健康干预是提高PCI术后患者对基于运动的二期心脏康复依从性的前两项干预措施。医疗服务提供者在临床实践中可能会考虑优先使用家庭心脏康复联合移动健康干预，但仍需评估患者偏好和医疗保险报销可用性等因素，以制定不仅安全有效而且令患者满意的定制干预措施。
