TY -的非盟Verhoeven Fenne AU - van Gemert-Pijnen Lisette AU -迪杰斯特拉,卡琳AU - Nijland盟——Seydel考Erwin盟——Steehouder迈克尔PY - 2007 DA - 2007/12/14 TI -糖尿病护理的远程咨询和视频会议的贡献:一个系统的文献回顾乔- J地中海互联网Res SP - e37六世- 9 - 5 KW -慢性病KW -糖尿病KW -远程医疗千瓦咨询KW -远程咨询KW -视频会议AB -背景:我们进行了系统的文献综述，研究远程会诊和视频会议在糖尿病护理多方面过程中的益处。以前的评论主要关注技术的可用性，考虑的主要是片面的干预。目的:目的是确定远程会诊和视频会议在糖尿病护理的临床、行为和护理协调结果方面的优点和不足。方法:检索相关出版物的电子数据库(Medline、PiCarta、psyinfo、ScienceDirect、Telemedicine Information Exchange、ISI Web of Science、谷歌Scholar)。从临床结果(如糖化血红蛋白、血压、生活质量)、行为结果(患者与护理人员的互动、自我护理)和护理协调结果(技术的可用性、成本效益、指南的透明度、护理获得的公平性)来检查对糖尿病护理的贡献。采用标准的meta分析方法汇总以HbA1c为结果的随机对照试验(rct)。结果:在识别的852份出版物中，39份符合护理人员与1型、2型或妊娠期糖尿病患者(组)之间电子通信的纳入标准。评估不特别针对糖尿病的远程会诊或视频会议的研究被排除在外，那些描述仅针对临床改善的干预措施的研究也被排除在外(如HbA1c)。22项干预措施与远程会诊有关，13项与视频会议有关，4项与远程会诊和视频会议联合有关。 The heterogeneous nature of the identified videoconferencing studies did not permit a formal meta-analysis. Pooled results from the six RCTs of the identified teleconsultation studies did not show a significant reduction in HbA1c (0.03%, 95% CI = - 0.31% to 0.24%) compared to usual care. There was no significant statistical heterogeneity among the pooled RCTs (χ27= 7.99, P = .33). It can be concluded that in the period under review (1994-2006) 39 studies had a scope broader than clinical outcomes and involved interventions allowing patient-caregiver interaction. Most of the reported improvements concerned satisfaction with technology (26/39 studies), improved metabolic control (21/39), and cost reductions (16/39). Improvements in quality of life (6/39 studies), transparency (5/39), and better access to care (4/39) were hardly observed. Teleconsultation programs involving daily monitoring of clinical data, education, and personal feedback proved to be most successful in realizing behavioral change and reducing costs. The benefits of videoconferencing were mainly related to its effects on socioeconomic factors such as education and cost reduction, but also on monitoring disease. Additionally, videoconferencing seemed to maintain quality of care while producing cost savings. Conclusions: The selected studies suggest that both teleconsultation and videoconferencing are practical, cost-effective, and reliable ways of delivering a worthwhile health care service to diabetics. However, the diversity in study design and reported findings makes a strong conclusion premature. To further the contribution of technology to diabetes care, interactive systems should be developed that integrate monitoring and personalized feedback functions. SN - 1438-8871 UR - //www.mybigtv.com/2007/5/e37/ UR - https://doi.org/10.2196/jmir.9.5.e37 UR - http://www.ncbi.nlm.nih.gov/pubmed/18093904 DO - 10.2196/jmir.9.5.e37 ID - info:doi/10.2196/jmir.9.5.e37 ER -