基于远程医疗的口服抗凝治疗管理:系统审查和元分析
Letícia Braga Ferreira1,2, Rodrigo Lanna de Almeida3, Alair Arantes1
1University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Journal of medical Internet research
|July 10, 2023
概括
对口服抗凝药管理的远程医疗显示了较少的血栓栓塞事件和改善抗凝药质量的趋势. 虽然严重出血和死亡率与常规护理相似,但远程医疗为远程患者访问提供了潜在的好处.
科学领域:
- 心脏病学 心脏病学
- 数字健康数字健康
- 基于证据的医学基于证据的医学.
背景情况:
- 口服抗凝药对于治疗各种疾病至关重要.
- 对口服抗凝药的有效管理提出了挑战.
- 远程医疗策略越来越多地用于支持抗凝治疗.
研究的目的:
- 系统地审查有关远程医疗对口服抗凝药管理影响的证据.
- 为了比较远程医疗与有关血栓栓塞和出血事件的通常护理.
- 评估对死亡率和治疗范围内的时间的影响.
主要方法:
- 对25项随机对照试验 (25,746名患者) 的系统综述.
- 从创建到2021年9月,搜索了5个数据库.
- 使用随机效应模型评估血栓栓塞事件,重大出血,死亡率和治疗范围内的时间.
主要成果:
- 远程医疗显示出较少的血栓栓塞事件 (RR 0.75) 的非显著趋势.
- 严重出血 (RR 0.94) 和死亡率 (RR 0.96) 与通常护理相比较.
- 观察到治疗范围的时间改善 (MD 3.38);多任务干预中血栓栓塞事件显著减少 (RR 0.20).
结论:
- 远程医疗管理提供了类似的安全性 (出血,死亡率),但更好的抗凝质量.
- 调查结果支持电子卫生对抗凝血的实施,特别是在多方面的干预中.
- 建议进一步对临床结果,成本效益和生活质量进行高质量的研究.
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