互联网医院全程管理对慢性非传染性疾病患者服药依从性及生活质量影响的Meta分析  

Meta⁃analysis of the Influence of Whole⁃course Management of Internet Hospitals on Medication Compliance and Quality of Life of Patients with Chronic Non⁃communicable Diseases

作　　者：李茹凡 李婷[2] 李蒙[2] LI Rufan;LI Ting;LI Meng(Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712046;The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《上海护理》2023年第7期59-65,共7页Shanghai Nursing

摘　　要：目的评价互联网医院全程管理对慢性非传染性疾病(简称慢性病)患者服药依从性及生活质量的影响。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、中国生物医学文献数据库、万方数据库、维普数据库及手动检索数据库中关于互联网医院全程管理对慢性病患者管理效果的随机对照试验,检索时限为建库起至2022年3月。由2名经过循证护理培训的研究者独立筛选文献、质量评价、提取资料,采用RevMan5.3软件进行Meta分析。结果共纳入13篇文献(涉及5239例患者),纳入文献的方法学质量较高,但异质性较大。Meta分析结果显示,实验组(在传统慢性病管理的基础上采用互联网医院全程管理)服药依从性优于对照组(采用传统慢性病管理模式)[OR=3.02,95%CI(1.98,4.60),Z=5.15,P<0.01],生活质量得分高于对照组[SMD=0.90,95%CI(0.32,1.48),Z=3.04,P<0.01],差异均具有统计学意义;对患者服药依从性进行敏感性分析显示,各研究间无异质性(I²=6%,P<0.01),合并效应值OR=4.15(Z=5.61,P<0.01)。结论目前证据表明,互联网医院全程管理可提高慢性病患者服药依从性、改善其生活质量,建议今后开展更多高质量、多中心的随机对照研究,为未来互联网医院全程管理模式的推广使用提供更有力的循证依据。Objective To evaluate the influence of whole-course management of Internet hospitals on medication compliance and quality of life of patients with chronic non-communicable diseases(chronic diseases).Methods Randomized controlled trials on the effect of whole-course management of Internet hospitals on patients with chronic diseases were retrieved in PubMed,Embase,Web of Science,The Cochrane Library,CNKI,CBMdisc,Wanfang Data and VIP on the computer and manually,from the establishment of database to March 2022.Two investigators who were participated in evidence-based nursing training independently screened the literature,evaluated literature quality and extracted information,and then conducted a Meta-analysis with RevMan5.3 software.Results A total of 13 articles(involving 5239 patients)were included,which had high methodological quality yet high heterogeneity.The results of Meta-analysis showed that the medication compliance of the experimental group(whole-course management of Internet hospitals,based on traditional chronic disease management)was better than that of the control group(traditional chronic disease management)[OR=3.02,95%CI(1.98,4.60),Z=5.15,P<0.01],and the quality of life score was higher than that of the control group[SMD=0.90,95%CI(0.32,1.48),Z=3.04,P<0.01],with statistical difference;sensitivity analysis on medication compliance showed that there was no heterogeneity among studies(I2=6%,P<0.01),and the pooled effect size OR=4.15(Z=5.61,P<0.01).Conclusion At present,the evidence shows that the wholecourse management of Internet hospitals improves the medication compliance of patients with chronic diseases and enhances their quality of life.It is suggested to carry out more high-quality,multi-center randomized controlled studies in the future to provide more evidence-based basis for the promotion and use of the wholecourse management model of Internet hospitals in the future.

关 键 词：互联网医院 慢性病非传染性疾病 全程管理 慢性病管理 服药依从性 生活质量 

分 类 号：R473[医药卫生—护理学]