互联网自我健康管理对慢性病共病患者的影响：一项为期4年的纵向研究。
The effects of internet self-health management on patients with chronic disease multimorbidity: a 4-year longitudinal study.
作者信息
Wang Yuyang, Hu Qiang, Chen Botian, Ma Defu
机构信息
Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China.
出版信息
Front Digit Health. 2025 Jul 30;7:1568743. doi: 10.3389/fdgth.2025.1568743. eCollection 2025.
BACKGROUND
The escalating global burden of chronic diseases has given rise to a growing population affected by multimorbidity, defined as the co-occurrence of two or more chronic conditions. This health phenomenon is exacerbating disease burden through compounded clinical complications and increased healthcare demands. This study evaluates the effectiveness of internet-based self-health management in improving health behaviors and clinical indicators in patients with multimorbidity.
METHODS
A total of 30,745 adults aged ≥18 years from five northwestern Chinese provinces were enrolled. Following baseline data collection in 2013, participants received structured online health guidance covering diet nutrition, physical activity, and mental well-being. A follow-up assessment was conducted in 2017, involving questionnaire surveys and clinical measurements. Changes in health behaviors and clinical indicators of 2,535 patients with multimorbidity were analyzed. Binary logistic regression models were employed to identify factors influencing multimorbidity management outcomes.
RESULTS
The prevalence of multimorbidity at baseline in this study was 7.9%. After four years of health management, significant improvements were observed: smoking cessation rates increased from 8.2% to 10.2%, while low physical activity decreased from 29.0% to 24.6%. Both healthy individuals and multimorbid patients showed an increase in soybeans and nuts intake from 2013 to 2017. The fasting plasma glucose of the multimorbidity subjects decreased from 9.33 mmol/L in 2013 to 8.28 mmol/L in 2017, and the total cholesterol level decreased from 6.97 mmol/L to 6.26 mmol/L ( < 0.001). Significant reductions were also observed in triglycerides and low-density lipoprotein cholesterol levels ( < 0.001). The binary logistic regression results showed that being 40 years or older, male, having a family history of chronic diseases, changes in smoking status and sleep quality under health management guidance were influencing factors for effective control of multimorbidity.
CONCLUSION
Internet-based self-health management effectively improves health behaviors and clinical indicators in patients with chronic disease multimorbidity.
背景
全球慢性病负担不断加剧，导致受多种慢性病共存（即两种或更多种慢性病同时出现）影响的人口日益增多。这种健康现象通过复杂的临床并发症和增加的医疗需求加剧了疾病负担。本研究评估基于互联网的自我健康管理在改善多种慢性病患者健康行为和临床指标方面的有效性。
方法
招募了来自中国西北五省的30745名年龄≥18岁的成年人。在2013年收集基线数据后，参与者接受了涵盖饮食营养、身体活动和心理健康的结构化在线健康指导。2017年进行了随访评估，包括问卷调查和临床测量。分析了2535名患有多种慢性病患者的健康行为和临床指标的变化。采用二元逻辑回归模型确定影响多种慢性病管理结果的因素。
结果
本研究中基线时多种慢性病的患病率为7.9%。经过四年的健康管理，观察到显著改善：戒烟率从8.2%提高到10.2%，而身体活动不足从29.0%降至24.6%。从2013年到2017年，健康个体和患有多种慢性病的患者大豆和坚果摄入量均有所增加。患有多种慢性病的受试者空腹血糖从2013年的9.33 mmol/L降至2017年的8.28 mmol/L，总胆固醇水平从6.97 mmol/L降至6.26 mmol/L（P<0.001）。甘油三酯和低密度脂蛋白胆固醇水平也显著降低（P<0.001）。二元逻辑回归结果显示，40岁及以上、男性、有慢性病家族史、在健康管理指导下吸烟状况和睡眠质量的变化是有效控制多种慢性病的影响因素。
结论
基于互联网的自我健康管理有效地改善了患有慢性病多种并发症患者的健康行为和临床指标。
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