TY - JOUR AU - Ögmundsdóttir Michelsen, Halldóra AU - Sjölin, Ingela AU - Bäck, Maria AU - Gonzalez Garcia, Manuel AU - Olsson, Anneli AU - Sandberg, Camilla AU - Schiopu, Alexandru AU - Leósdóttir, Margrét PY - 2022 DA - 2022/3/31 TI -以生活方式为中心的web应用程序对心肌梗死患者危险因素管理的影响:随机对照试验JO - J Med Internet Res SP - e25224 VL - 24 IS - 3kw - eHealth KW -心脏康复KW -心血管KW -移动设备应用KW -危险因素KW -网络应用KW -手机AB -背景:心脏康复是降低心肌梗死后死亡率和发病率的中心。然而，指南推荐的心脏康复指标的实现并不令人满意。电子健康为改善临床护理提供了新的可能性。目的:本研究旨在评估一个基于web的应用程序的效果，该应用程序旨在支持在基于中心的心脏康复之外坚持生活方式建议和风险因素的自我控制(干预)，与仅进行心脏康复(常规护理)相比。方法:150例患者均参加心脏康复治疗。随机分配到干预组(n=101)的患者可以使用该应用程序25周，其中可以记录生活方式(如饮食和身体活动)、危险因素(如体重和血压[BP])和症状。该软件提供反馈和生活方式建议。主要转归为随访期间次最大运动能力(Watts [W])的变化。次要结果包括基线和随访之间可修改的危险因素的变化以及对应用的接受和坚持。 Regression analysis was used, adjusting for relevant baseline variables. Results: There was a nonsignificant trend toward a larger change in exercise capacity in the intervention group (n=66) compared with the usual care group (n=40; +14.4, SD 19.0 W, vs +10.3, SD 16.1 W; P=.22). Patients in the intervention group achieved significantly larger BP reduction compared with usual care patients at 2 weeks (systolic −27.7 vs −16.4 mm Hg; P=.006) and at 6 to 10 weeks (systolic −25.3 vs −16.4 mm Hg; P=.02, and diastolic −13.4 vs −9.1 mm Hg; P=.05). A healthy diet index score improved significantly more between baseline and the 2-week follow-up in the intervention group (+2.3 vs +1.4 points; P=.05), mostly owing to an increase in the consumption of fish and fruit. At 6 to 10 weeks, 64% (14/22) versus 46% (5/11) of smokers in the intervention versus usual care groups had quit smoking, and at 12 to 14 months, the respective percentages were 55% (12/22) versus 36% (4/11). However, the number of smokers in the study was low (33/149, 21.9%), and the differences were nonsignificant. Attendance in cardiac rehabilitation was high, with 96% (96/100) of patients in the intervention group and 98% (48/49) of patients receiving usual care only attending 12- to 14-month follow-up. Uptake (logging data in the application at least once) was 86.1% (87/101). Adherence (logging data at least twice weekly) was 91% (79/87) in week 1 and 56% (49/87) in week 25. Conclusions: Complementing cardiac rehabilitation with a web-based application improved BP and dietary habits during the first months after myocardial infarction. A nonsignificant tendency toward better exercise capacity and higher smoking cessation rates was observed. Although the study group was small, these positive trends support further development of eHealth in cardiac rehabilitation. Trial Registration: ClinicalTrials.gov NCT03260582; https://clinicaltrials.gov/ct2/show/NCT03260582 International Registered Report Identifier (IRRID): RR2-10.1186/s13063-018-3118-1 SN - 1438-8871 UR - //www.mybigtv.com/2022/3/e25224 UR - https://doi.org/10.2196/25224 UR - http://www.ncbi.nlm.nih.gov/pubmed/35357316 DO - 10.2196/25224 ID - info:doi/10.2196/25224 ER -