心不全患者の遠隔医療介入管理の有効性 (TIM-HF2):ランダム化,制御,並列群,非マスク試験
Friedrich Koehler1, Kerstin Koehler1, Oliver Deckwart1
1Centre for Cardiovascular Telemedicine, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Lancet (London, England)
|August 30, 2018
まとめ
心不全患者の遠隔管理により,入院と全因死亡率が著しく減少しました. 早期発見と迅速な治療を可能にし,患者のケアを改善します.
科学分野:
- 心臓病科
- デジタル・ヘルス
- 臨床試験
背景:
- 遠隔管理 (RPM) は,心不全患者における心不全の早期徴候を検出することができる.
- 治療を早期に開始すると,重度のHF解消を防ぐことができます.
- HF集団における死亡率と罹患率に対するRPMの有効性は,調査が必要です.
研究 の 目的:
- 明確に定義された心不全集団における死亡率と罹患率に対する遠隔患者管理介入の有効性を調査する.
- 心血管疾患による不計画入院や全因死亡の減少に RPM の影響を評価する.
主な方法:
- ドイツでの将来性,ランダム化,制御された多センター試験 (TIM-HF2).
- 1571人のHF患者 (NYHAクラスII/III,LVEF≤45%) をランダムにRPM+通常治療または通常治療のみに割り当てました.
- 最長393日間の追跡調査で,主なアウトカム: 予期せぬ心血管疾患の入院や全原因の死亡により失われた日数
主要な成果:
- RPMグループは,通常のケアでは6. 64%に対して,計画外入院/死亡で4. 88%の日を失いました (p=0. 0460).
- 年間平均 失われた日数: 17. 8 (RPM) 対 24. 2 (通常のケア).
- すべての原因による死亡率はRPM群で低かった (7. 86対11. 34/100人年; p=0. 0280).
結論:
- 組織化された遠隔管理による介入は,心血管疾患の予期せぬ入院日数と全因死亡率を減少させます.
- RPMは心臓機能不全の患者の管理に有効な戦略であり,長期的な結果を改善する可能性があります.
- 心血管疾患による死亡率の違いと 長期的な利益について 更に研究が進められるでしょう
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