@Article{信息:doi 10.2196 / / jmir。4059，作者="Karhula, Tuula和Vuorinen, Anna-Leena和R{"a}{"a}pysj{"a}rvi, Katja和Pakanen, Mira和Itkonen, Pentti和Tepponen, Merja和Junno, Ulla-Maija和Jokinen, Tapio和van Gils, Mark和L{"a " hteenm{"a " ki, Jaakko和Kohtam{"a " ki, Kari和Saranummi, Niilo"，标题="芬兰糖尿病和心脏病患者中基于远程监测和移动电话的健康指导:随机对照试验”，期刊=“J Med Internet Res”，年=“2015”，月=“6”，日=“17”，卷=“17”，数=“6”，页数=“e153”，关键词=“健康教练;远程控制;2型糖尿病;心脏病;个人健康记录;背景:由于慢性疾病负担不断增加，人们有强烈的意愿和需要寻找医疗保健交付的替代模式。目的:这项为期1年的试验旨在研究在远程监测系统支持下，基于手机的结构化健康指导计划是否可用于改善2型糖尿病和心脏病患者的健康相关生活质量(HRQL)和/或临床指标。方法:在南卡累利阿社会和卫生保健区2型糖尿病患者和心脏病患者中进行了一项随机对照试验。 Patients were recruited by sending invitations to randomly selected patients using the electronic health records system. Health coaches called patients every 4 to 6 weeks and patients were encouraged to self-monitor their weight, blood pressure, blood glucose (diabetics), and steps (heart disease patients) once per week. The primary outcome was HRQL measured by the Short Form (36) Health Survey (SF-36) and glycosylated hemoglobin (HbA1c) among diabetic patients. The clinical measures assessed were blood pressure, weight, waist circumference, and lipid levels. Results: A total of 267 heart patients and 250 diabetes patients started in the trial, of which 246 and 225 patients concluded the end-point assessments, respectively. Withdrawal from the study was associated with the patients' unfamiliarity with mobile phones---of the 41 dropouts, 85{\%} (11/13) of the heart disease patients and 88{\%} (14/16) of the diabetes patients were familiar with mobile phones, whereas the corresponding percentages were 97.1{\%} (231/238) and 98.6{\%} (208/211), respectively, among the rest of the patients (P=.02 and P=.004). Withdrawal was also associated with heart disease patients' comorbidities---40{\%} (8/20) of the dropouts had at least one comorbidity, whereas the corresponding percentage was 18.9{\%} (47/249) among the rest of the patients (P=.02). The intervention showed no statistically significant benefits over the current practice with regard to health-related quality of life---heart disease patients: beta=0.730 (P=.36) for the physical component score and beta=-0.608 (P=.62) for the mental component score; diabetes patients: beta=0.875 (P=.85) for the physical component score and beta=-0.770 (P=.52) for the mental component score. There was a significant difference in waist circumference in the type 2 diabetes group (beta=-1.711, P=.01). There were no differences in any other outcome variables. Conclusions: A health coaching program supported with telemonitoring did not improve heart disease patients' or diabetes patients' quality of life or their clinical condition. There were indications that the intervention had a differential effect on heart patients and diabetes patients. Diabetes patients may be more prone to benefit from this kind of intervention. This should not be neglected when developing new ways for self-management of chronic diseases. Trial Registration: ClinicalTrials.gov NCT01310491; http://clinicaltrials.gov/ct2/show/NCT01310491 (Archived by WebCite at http://www.webcitation.org/6Z8l5FwAM). ", issn="1438-8871", doi="10.2196/jmir.4059", url="//www.mybigtv.com/2015/6/e153/", url="https://doi.org/10.2196/jmir.4059", url="http://www.ncbi.nlm.nih.gov/pubmed/26084979" }