TY - JOUR AU - Aardoom, Jiska Joëlle AU - Loheide-Niesmann, Lisa AU - Ossebaard, Hans C AU - Riper, Heleen PY - 2020 DA - 2020/2/18 TI -电子健康干预提高成人阻塞性睡眠呼吸暂停患者治疗依从性的有效性:meta分析综述JO - J Med Internet Res SP - e16972 VL - 22 IS - 2kw -阻塞性睡眠呼吸暂停KW -持续气道正压治疗依从性KW -患者依从性KW -远程医疗KW - eHealth KW - meta分析KW -系统综述AB -背景:阻塞性睡眠呼吸暂停(OSA)成人持续气道正压(CPAP)治疗依从性差是一个常见问题。通过信息和通信技术(即电子保健)提供的战略可以通过对患者进行教育、实时监测呼吸暂停症状和日常生活中的持续呼吸pap坚持、自我管理以及在设备或治疗出现问题时早期识别和随后的干预来解决治疗依从性问题。然而，现有的电子健康技术在改善CPAP依从性方面的有效性尚未得到系统的研究。目的:本荟萃分析综述旨在调查广泛的电子健康干预措施在提高CPAP治疗依从性方面的有效性。方法:对Cochrane Library、PsycINFO、PubMed和Embase数据库进行系统文献检索，确定成人OSA人群的相关随机对照试验。纳入研究的偏倚风险使用Cochrane协作风险偏倚工具的七个项目进行检查。荟萃分析采用综合荟萃分析软件进行，该软件计算了平均干预后依从性(MD)的差异，MD定义为使用CPAP的平均夜间小时数。结果:荟萃分析最终纳入18项研究(N=5429名OSA成人)，包括22项实验条件和对照条件的比较。根据实验干预的时间长短，在基线后1至6个月评估干预后数据。 eHealth interventions increased the average nightly use of CPAP in hours as compared with care as usual (MD=0.54, 95% CI 0.29-0.79). Subgroup analyses did not reveal significant differences in effects between studies that used eHealth as an add-on or as a replacement to care as usual (P=.95), between studies that assessed stand-alone eHealth and blended strategies combining eHealth with face-to-face care (P=.23), or between studies of fully automated interventions and guided eHealth interventions (P=.83). Evidence for the long-term follow-up effectiveness of eHealth adherence interventions remains undecided owing to a scarcity of available studies and their mixed results. Conclusions: eHealth interventions for adults with OSA can improve adherence to CPAP in the initial months after the start of treatment, increasing the mean nightly duration of use by about half an hour. Uncertainty still exists regarding the timing, duration, intensity, and specific types of eHealth interventions that could be most effectively implemented by health care providers. SN - 1438-8871 UR - //www.mybigtv.com/2020/2/e16972 UR - https://doi.org/10.2196/16972 UR - http://www.ncbi.nlm.nih.gov/pubmed/32130137 DO - 10.2196/16972 ID - info:doi/10.2196/16972 ER -