芬兰糖尿病和心脏病患者的远程监测和基于手机的健康指导:卡塔尔世界杯8强波胆分析随机对照试验%A Karhula,Tuula %A Vuorinen,Anna-Leena %A Rääpysjärvi,Katja %A Pakanen,Mira %A Itkonen,Pentti %A Tepponen,Merja %A Junno,Ulla-Maija %A Jokinen,Tapio %A van Gils,Mark %A Lähteenmäki,Jaakko %A Kohtamäki,Kari %A Saranummi，芬兰Niilo %+ VTT技术研究中心，邮政信箱1300，芬兰，FI-33101, 358 408485966，anna-leena.vuorinen@vtt.fi %K健康指导%K远程监测%K 2型糖尿病%K心脏病%K个人健康记录%K健康相关生活质量%D 2015 %7 2015年6月17日%9原始论文%J J医学互联网Res %G英语%X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。通过使用电子健康记录系统向随机选择的患者发送邀请来招募患者。健康教练每4到6周给患者打电话，鼓励患者每周自我监测一次体重、血压、血糖(糖尿病患者)和步数(心脏病患者)。主要终点是通过SF-36健康调查(Short Form (36) Health Survey, SF-36)和糖化血红蛋白(糖化血红蛋白，HbA1c)测量糖尿病患者的HRQL。评估的临床指标包括血压、体重、腰围和血脂水平。结果:共有267名心脏病患者和250名糖尿病患者参加了试验，其中246名和225名患者分别完成了终点评估。 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). %M 26084979 %R 10.2196/jmir.4059 %U //www.mybigtv.com/2015/6/e153/ %U https://doi.org/10.2196/jmir.4059 %U http://www.ncbi.nlm.nih.gov/pubmed/26084979