TY -非盟的刘fireworks AU -李,辑里非盟- Wan, Ding-yuan AU - Li Runyi盟——瞿,詹AU -胡,Yundi盟——刘,佳林PY - 2022 DA - 2022/9/26 TI -电子健康自我管理干预措施的有效性在心力衰竭患者:系统回顾和荟萃分析乔- J地中海互联网Res SP - e38697六世- 24 - 9千瓦心力衰竭KW -电子健康KW -自我管理千瓦系统回顾KW -心脏病KW -心血管KW -发病率AB -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地回顾电子健康自我管理对心衰患者有效性的证据。方法:本研究仅纳入随机对照试验(rct)，通过检索2011年1月1日至2022年7月12日的EMBASE、PubMed、CENTRAL (Cochrane中央对照试验登记册)和CINAHL数据库，比较了电子健康干预措施与常规护理对成年心梗患者的效果。使用Cochrane偏倚风险工具(RoB 2)评估每项研究的偏倚风险。推荐、评估、发展和评估的分级(GRADE)标准用于对每个相关结果的证据的确定性进行分级。采用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名参与者符合纳入标准。与常规护理组相比，电子健康自我管理干预可显著降低全因死亡率(优势比[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. SN - 1438-8871 UR - //www.mybigtv.com/2022/9/e38697 UR - https://doi.org/10.2196/38697 UR - http://www.ncbi.nlm.nih.gov/pubmed/36155484 DO - 10.2196/38697 ID - info:doi/10.2196/38697 ER -