@Article{信息:doi 10.2196 / / jmir。4417，作者=“Agboola, Stephen and Jethwani, Kamal and Khateeb, Kholoud and Moore, Stephanie and Kvedar, Joseph”，标题=“心力衰竭远程监测:来自真实世界远程监测程序回顾性评估的证据”，期刊=“J Med Internet Res”，年=“2015”，月=“Apr”，日=“22”，卷=“17”，数=“4”，页=“e101”，关键词=“心力衰竭;远程控制;远程监控;自我管理;住院治疗;背景:考虑到心力衰竭死亡率的增加，建议以疾病管理计划和其他综合护理模式的形式采用多学科方法来优化治疗结果。远程监测，无论是结构化的电话支持或远程监测，还是两者的结合，正迅速成为许多疾病管理计划的一个组成部分。然而，关于评估真实世界心脏衰竭远程监测程序的研究报告很少。目的:本研究旨在评估心脏衰竭远程监测计划，连接心脏护理计划(CCCP)对住院和死亡率的影响，回顾性数据库回顾了在马萨诸塞州总医院接受护理的心力衰竭患者的医疗记录。 Methods: Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary outcomes included hospitalization and mortality rates (obtained by following up on patients over an additional 8 months after program completion for a total duration of 1 year), risk for multiple hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs, was used to assess primary outcomes. Results: A total of 348 patients were included in the time-to-event analyses. The baseline rates of hospitalizations prior to program enrollment did not differ significantly by group. Compared with controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio (HR)=0.52, 95{\%} CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained consistent until the end of the 4-month program (HR=0.74, 95{\%} CI 0.54-1.02, P=.06). The program was also associated with lower mortality rates at the end of the 4-month program: relative risk (RR)=0.33, 95{\%} 0.11-0.97, P=.04). Additional 8-months follow-up following program completion did not show residual beneficial effects of the CCCP program on mortality (HR=0.64, 95{\%} 0.34-1.21, P=.17) or hospitalizations (HR=1.12, 95{\%} 0.90-1.41, P=.31). Conclusions: CCCP was associated with significantly lower hospitalization rates up to 90 days and significantly lower mortality rates over 120 days of the program. However, these effects did not persist beyond the 120-day program duration. ", issn="1438-8871", doi="10.2196/jmir.4417", url="//www.mybigtv.com/2015/4/e101/", url="https://doi.org/10.2196/jmir.4417", url="http://www.ncbi.nlm.nih.gov/pubmed/25903278" }