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数字应用在炎症性风湿性疾病自我管理及其他结局方面的潜力:一项系统文献综述

Potential of digital applications for self-management and other outcomes in inflammatory rheumatic diseases: a systematic literature review.

作者信息

Volkmar Alina, von der Decken Cay-Benedict, Kleinert Stefan, Karberg Kirsten, Gauler Georg, Klennert Michael, Klennert Jana, Aries Peer Malte, Froschauer Sonja, Wildenhain Sarah, Muth Theresia, Späthling-Mestekemper Susanna, Kuhn Christoph, Vorbrüggen Wolfgang, Welcker Martin, Bartz-Bazzanella Peter, Englbrecht Matthias

机构信息

Faculty of Life Sciences, University of Applied Sciences, Hamburg, Germany.

RHADAR - RheumaDatenRheport GbR, Erlangen, Germany.

出版信息

Front Med (Lausanne). 2025 Jul 9;12:1617151. doi: 10.3389/fmed.2025.1617151. eCollection 2025.

Abstract

INTRODUCTION

Inflammatory rheumatic diseases (IRDs) are chronic autoimmune conditions affecting the musculoskeletal system, leading to pain, disability, and reduced quality of life. Despite advances in medical treatments, barriers such as delayed diagnosis, workforce shortages, and low adherence to self-management strategies remain critical challenges. Digital health applications are emerging as promising tools to enhance disease management. The aim of this study was to conduct a systematic literature review (SLR) to evaluate self-care outcomes associated with digital health applications in IRDs.

METHODS

We conducted a systematic literature review according to PRISMA guidelines across four electronic databases (PubMed, Embase, CINAHL, Cochrane) from inception to July 2024. Randomized controlled trials (RCTs) and systematic reviews focusing on digital interventions to promote self-management and self-care in individuals with IRDs were included. Key outcomes were extracted and the quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist.

RESULTS

Fifteen RCTs with a total of 1912 participants were analyzed. Primary outcomes, including self-management/self-care, showed mixed results. Some studies demonstrated significant improvements in self-efficacy, pain reduction, depression/anxiety symptoms, and physical function, while others showed no notable changes. Secondary outcomes, including disease activity and medication adherence, revealed heterogeneous findings. Variability in study design, sample size, and intervention duration posed challenges for drawing definitive conclusions about the effectiveness of digital interventions.

DISCUSSION

Digital health applications show promise as cost-effective and scalable solutions to complement standard IRD care by empowering patients in their disease management. However, significant heterogeneity and limited generalizability highlight the need for more robust and long-term research to validate the efficacy of specific tools and identify best options for improving outcomes. Tailored digital interventions could bridge the gap in care for IRD patients and support their autonomy.

摘要

引言

炎性风湿性疾病(IRDs)是影响肌肉骨骼系统的慢性自身免疫性疾病,会导致疼痛、残疾和生活质量下降。尽管医学治疗取得了进展,但诸如诊断延迟、劳动力短缺以及自我管理策略依从性低等障碍仍然是严峻的挑战。数字健康应用正成为增强疾病管理的有前景的工具。本研究的目的是进行一项系统文献综述(SLR),以评估与数字健康应用在炎性风湿性疾病中相关的自我护理结果。

方法

我们根据PRISMA指南,对从创刊到2024年7月的四个电子数据库(PubMed、Embase、CINAHL、Cochrane)进行了系统文献综述。纳入了聚焦于促进炎性风湿性疾病患者自我管理和自我护理的数字干预措施的随机对照试验(RCTs)和系统评价。提取关键结果,并使用批判性评估技能计划(CASP)清单评估纳入研究的质量。

结果

分析了15项随机对照试验,共有1912名参与者。包括自我管理/自我护理在内的主要结果显示出混合结果。一些研究表明在自我效能、疼痛减轻、抑郁/焦虑症状和身体功能方面有显著改善,而其他研究则未显示出明显变化。包括疾病活动和药物依从性在内的次要结果显示出异质性发现。研究设计、样本量和干预持续时间的差异给就数字干预措施的有效性得出明确结论带来了挑战。

讨论

数字健康应用有望成为具有成本效益且可扩展的解决方案,通过增强患者的疾病管理能力来补充标准的炎性风湿性疾病护理。然而,显著的异质性和有限的可推广性凸显了需要更有力和长期的研究来验证特定工具的疗效,并确定改善结果的最佳选择。量身定制的数字干预措施可以弥合炎性风湿性疾病患者护理方面的差距,并支持他们的自主性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06c9/12285587/e82fac21b9ca/fmed-12-1617151-g001.jpg

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