e - health自我管理干预在心力衰竭患者中的有效性:卡塔尔世界杯8强波胆分析系统综述与meta分析%A Liu，思如%A Li，吉力%A Wan，丁元%A Li，润一%A Qu，占%A Hu，云迪%A Liu，嘉林%+医疗信息科，四川大学华西医院，成都610041,86 02885422306,dljl8@163.com %K心力衰竭%K eHealth %K自我管理%K系统综述%K心脏病%K心血管%K发病率%D 2022 %7 26.9.2022 %9综述%J J医学互联网检索%G英文%X背景:心力衰竭(HF)是一种常见的临床综合征，发病率高，经济负担重，再入院风险高。电子健康自我管理干预可能是改善心衰临床结果的有效途径。目的:本研究的目的是系统回顾电子健康自我管理在心衰患者中的有效性的证据。方法:本研究仅包括随机对照试验(rct)，通过搜索2011年1月1日至2022年7月12日期间的EMBASE、PubMed、CENTRAL (Cochrane中央对照试验注册中心)和CINAHL数据库，比较eHealth干预与常规护理对心力衰竭成年患者的效果。使用Cochrane偏倚风险工具(RoB 2)评估每项研究的偏倚风险。建议分级、评估、发展和评价(GRADE)标准用于对每个感兴趣结果的证据的确定性进行评级。使用Review Manager (RevMan v.5.4)和R (v.4.1.0 x64)软件进行meta分析。结果:共有24项rct, 9634名受试者符合纳入标准。 Compared with the usual-care group, eHealth self-management interventions could significantly reduce all-cause mortality (odds ratio [OR] 0.83, 95% CI 0.71-0.98, P=.03; GRADE: low quality) and cardiovascular mortality (OR 0.74, 95% CI 0.59-0.92, P=.008; GRADE: moderate quality), as well as all-cause readmissions (OR 0.82, 95% CI 0.73-0.93, P=.002; GRADE: low quality) and HF-related readmissions (OR 0.77, 95% CI 0.66-0.90, P<.001; GRADE: moderate quality). The meta-analyses also showed that eHealth interventions could increase patients’ knowledge of HF and improve their quality of life, but there were no statistically significant effects. However, eHealth interventions could significantly increase medication adherence (OR 1.82, 95% CI 1.42-2.34, P<.001; GRADE: low quality) and improve self-care behaviors (standardized mean difference –1.34, 95% CI –2.46 to –0.22, P=.02; GRADE: very low quality). A subgroup analysis of primary outcomes regarding the enrolled population setting found that eHealth interventions were more effective in patients with HF after discharge compared with those in the ambulatory clinic setting. Conclusions: eHealth self-management interventions could benefit the health of patients with HF in various ways. However, the clinical effects of eHealth interventions in patients with HF are affected by multiple aspects, and more high-quality studies are needed to demonstrate effectiveness. %M 36155484 %R 10.2196/38697 %U //www.mybigtv.com/2022/9/e38697 %U https://doi.org/10.2196/38697 %U http://www.ncbi.nlm.nih.gov/pubmed/36155484