使用移动电话技术进行家庭远程监护对急性失代偿后心力衰竭患者结局的影响:随机对照试验%A Scherr,Daniel %A Kastner,Peter %A Kollmann,Alexander %A Hallas,Andreas %A Auer,Johann %A Krappinger,Heinz %A Schuchlenz,Herwig %A Stark,Gerhard %A Grander,Wilhelm %A Jakl,Gabriele %A Schreier,Guenter %A Fruhwald,Friedrich M %A， +大学内科诊所心内科，Auenbruggerplatz 15, A-8036 Graz，奥地利，+43 316 385 2544，friedrich.fruhwald@medunigraz.at %K心力衰竭%K远程医疗%K手机%K电子健康%D 2009 %7 17.8.2009 %9原始论文%J J医学互联网Res %G英文%X背景:慢性心力衰竭(CHF)患者的远程监测是一个新兴的概念，用于检测即将发生的急性失代偿的早期预警信号，以防止住院。目的:心衰患者移动远程监护研究(MOBITEL)的目的是评估使用互联网和手机技术的家庭远程监护对急性失代偿后心衰患者结局的影响。方法:将患者随机分为药物治疗组(对照组)和远程监护药物治疗组(远程组)，为期6个月。随机分为远程组的患者配备了基于手机的患者终端，用于数据采集和数据传输到监测中心。参与研究的医生可以通过一个安全的门户网站持续访问数据。如果传输的值超出了可单独调整的边界，研究医生会收到一封电子邮件提醒。主要终点为因心力衰竭恶化而住院或因心血管原因死亡。结果:120例患者(男性85例，女性35例)随机分组后停止研究; median age was 66 years (IQR 62-72). The control group comprised 54 patients (39 male, 15 female) with a median age of 67 years (IQR 61-72), and the tele group included 54 patients (40 male, 14 female) with a median age of 65 years (IQR 62-72). There was no significant difference between groups with regard to baseline characteristics. Twelve tele group patients were unable to begin data transmission due to the inability of these patients to properly operate the mobile phone (“never beginners”). Four patients did not finish the study due to personal reasons. Intention-to-treat analysis at study end indicated that 18 control group patients (33%) reached the primary endpoint (1 death, 17 hospitalizations), compared with 11 tele group patients (17%, 0 deaths, 11 hospitalizations; relative risk reduction 50%, 95% CI 3-74%, P = .06). Per-protocol analysis revealed that 15% of tele group patients (0 deaths, 8 hospitalizations) reached the primary endpoint (relative risk reduction 54%, 95% CI 7-79%, P= .04). NYHA class improved by one class in tele group patients only (P< .001). Tele group patients who were hospitalized for worsening heart failure during the study had a significantly shorter length of stay (median 6.5 days, IQR 5.5-8.3) compared with control group patients (median 10.0 days, IQR 7.0-13.0; P= .04). The event rate of never beginners was not higher than the event rate of control group patients. Conclusions: Telemonitoring using mobile phones as patient terminals has the potential to reduce frequency and duration of heart failure hospitalizations. Providing elderly patients with an adequate user interface for daily data acquisition remains a challenging component of such a concept. %M 19687005 %R 10.2196/jmir.1252 %U //www.mybigtv.com/2009/3/e34/ %U https://doi.org/10.2196/jmir.1252 %U http://www.ncbi.nlm.nih.gov/pubmed/19687005

map