@Article{信息:doi 10.2196 / / jmir。4550，作者=“Piette, John D和Striplin, Dana和Marinec, Nicolle和Chen, Jenny和Trivedi, Ranak B和Aron, David C和Fisher, Lawrence和Aikens, James E”，标题=“支持心力衰竭患者及其非正式照护者的移动健康干预:随机比较有效性试验”，期刊=“J Med Internet Res”，年=“2015”，月=“Jun”，日=“10”，卷=“17”，数=“6”，页=“e142”，关键词=“远程医疗;移动健康;心力衰竭;疾病管理;背景:移动健康(mHealth)干预可以改善心力衰竭(HF)的自我护理，但标准模型不能解决非正式护理人员对患者状态信息或护理人员如何提供帮助的需求。目的:我们对心衰患者护理人员的移动健康支持进行了评估，超过了标准移动健康方法的影响。方法:我们确定了331名来自退伍军人事务部门诊的心衰患者。所有患者都在他们的家庭之外找到了一个“护理伙伴”。随机分配到“标准移动健康”(n=165)的患者接受了12个月的每周交互式语音应答(IVR)电话，包括关于他们的健康和自我管理的问题。 Based on patients' responses, they received tailored self-management advice, and their clinical team received structured fax alerts regarding serious health concerns. Patients randomized to ``mHealth+CP'' (n=166) received an identical intervention, but with automated emails sent to their CarePartner after each IVR call, including feedback about the patient's status and suggestions for how the CarePartner could support disease care. Self-care and symptoms were measured via 6- and 12-month telephone surveys with a research associate. Self-care and symptom data also were collected through the weekly IVR assessments. Results: Participants were on average 67.8 years of age, 99{\%} were male (329/331), 77{\%} where white (255/331), and 59{\%} were married (195/331). During 15,709 call-weeks of attempted IVR assessments, patients completed 90{\%} of their calls with no difference in completion rates between arms. At both endpoints, composite quality of life scores were similar across arms. However, more mHealth+CP patients reported taking medications as prescribed at 6 months (8.8{\%} more, 95{\%} CI 1.2-16.5, P=.02) and 12 months (13.8{\%} more, CI 3.7-23.8, P<.01), and 10.2{\%} more mHealth+CP patients reported talking with their CarePartner at least twice per week at the 6-month follow-up (P=.048). mHealth+CP patients were less likely to report negative emotions during those interactions at both endpoints (both P<.05), were consistently more likely to report taking medications as prescribed during weekly IVR assessments, and also were less likely to report breathing problems or weight gains (all P<.05). Among patients with more depressive symptoms at enrollment, those randomized to mHealth+CP were more likely than standard mHealth patients to report excellent or very good general health during weekly IVR calls. Conclusions: Compared to a relatively intensive model of IVR monitoring, self-management assistance, and clinician alerts, a model including automated feedback to an informal caregiver outside the household improved HF patients' medication adherence and caregiver communication. mHealth+CP may also decrease patients' risk of HF exacerbations related to shortness of breath and sudden weight gains. mHealth+CP may improve quality of life among patients with greater depressive symptoms. Weekly health and self-care monitoring via mHealth tools may identify intervention effects in mHealth trials that go undetected using typical, infrequent retrospective surveys. Trial Registration: ClinicalTrials.gov NCT00555360; https://clinicaltrials.gov/ct2/show/NCT00555360 (Archived by WebCite at http://www.webcitation.org/6Z4Tsk78B). ", issn="1438-8871", doi="10.2196/jmir.4550", url="//www.mybigtv.com/2015/6/e142/", url="https://doi.org/10.2196/jmir.4550", url="http://www.ncbi.nlm.nih.gov/pubmed/26063161" }