移动健康医疗管理对高血压患者药物治疗依从性影响的系统评价  

Systematic Review of Effects of Mobile Health Care Management on Medication Compliance of Patients with Hypertension

作　　者：王佳芮 俞琼[2] 艾超 WANG Jiarui;YU Qiong;AI Chao(The Second Clinical Medial College of Jilin University,Jilin Changchun 130041,China;School of Public Health,Jilin University,Jilin Changchun 130021,China;Dept.of Pharmacy,Tsinghua Changgeng Hospital,Beijing 102218,China)

机构地区：[1]吉林大学第二临床医学院,吉林长春130041 [2]吉林大学公共卫生学院,吉林长春130021 [3]清华长庚医院药剂科,北京102218

出　　处：《中国医院用药评价与分析》2021年第12期1504-1509,共6页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价移动健康医疗管理对高血压患者药物治疗依从性的影响。方法:检索Pub Med、中国知网和万方数据库等期刊数据库,收集有关移动健康医疗管理对高血压患者药物治疗依从性影响的随机对照研究文献(对照组采用常规药物治疗+护理的常规管理方式,研究组在对照组常规管理的基础上又采用移动健康设备辅助干预)。根据研究目的筛选文献后,对文献进行质量评价,采用Rev Man 5.3软件进行荟萃分析(Meta分析)。结果:最终纳入12篇文献,共2 371例患者(研究组患者1 184例,对照组患者1 187例)。Meta分析结果显示,与常规管理方式比较,应用移动健康医疗管理方式后,高血压患者的药物治疗依从性评分明显改善,差异有统计学意义(SMD=0.76,95%CI=0.51~1.00,P <0.000 01);应用移动健康医疗管理3个月就可以有效提高患者的药物治疗依从性评分(SMD=0.94,95%CI=0.19~1.68,P=0.01),持续至12个月时患者的药物治疗依从性评分依然较高(SMD=0.96,95%CI=0.40~1.51,P=0.000 7),与常规管理方式比较,差异均有统计学意义。应用移动健康医疗管理3个月时,患者收缩压降低最明显[MD=-7.63 mm Hg(1 mm Hg=0.133 kPa),95%CI=-12.39~-2.86,P=0.002],至6个月时患者收缩压仍明显降低(MD=-5.55 mm Hg,95%CI=-7.68~-3.42,P <0.000 01)(但幅度小于3个月时),与常规管理方式比较,差异均有统计学意义。应用移动健康医疗管理6个月时,患者舒张压降低最明显,与常规管理方式比较,差异有统计学意义(MD=-3.36 mm Hg,95%CI=-5.11~-1.62,P=0.000 2)。患者血压降低趋势持续至应用移动健康医疗管理12个月时。结论:移动健康医疗管理对高血压等慢性病患者的药物治疗和管理具有优势,可在未来的医疗服务中发挥重要作用。OBJECTIVE: To systematically evaluate the effects of mobile health care management on medication compliance of patients with hypertension. METHODS: PubMed,CNKI and Wanfang Data were retrieved to collect the randomized controlled trials of effects of mobile health care management on medication compliance of patients with hypertension( the control group was treated with conventional medication treatment + nursing care management,while the study group received intervention of mobile health care management on the basis of routine management of the control group). After literature screening according to the research objectives,literature quality was evaluated,and Meta-analysis was performed by using RevMan 5. 3 software. RESULTS: Totally 12 articles were enrolled,including2 371 patients( 1 184 patients in the study group and 1 187 patients in the control group). Meta-analysis showed that compared with the conventional management,after the application of mobile health care management methods,the medication compliance scores of patients with hypertension were significantly improved,and the difference was statistically significant( SMD = 0. 76,95% CI = 0. 51-1. 00,P < 0. 000 01). Compared with the conventional management,the application of mobile health care management could effectively improve the medication compliance scores for 3 months( SMD = 0. 94,95% CI = 0. 19-1. 68,P = 0. 01),and the medication compliance scores remained at the high level for 12 months( SMD = 0. 96,95% CI = 0. 40-1. 51,P = 0. 000 7),the differences were statistically significant. The most significant reduction in systolic pressure was observed at 3 months of mobile health care management application[MD =-7. 63 mm Hg( 1 mm Hg = 0. 133 kPa),95% CI =-12. 39--2. 86,P = 0. 002],and the patients still had significantly lower systolic pressure at 6 months( MD =-5. 55 mm Hg,95% CI =-7. 68--3. 42,P < 0. 000 01)( but the magnitude was less than at 3 months),the differences were statistically significant compared with the conventional management. Patients s

关 键 词：收缩压 舒张压 遵医行为 药物治疗依从性 移动健康医疗 Meta分析 

分 类 号：R972.4[医药卫生—药品]