最近心力衰竭入院后基于自动短信的多方面的策略:MESSAGE-HF随机临床试验
Luis E Rohde1, Marciane M Rover2, Conrado R Hoffmann Filho3
1Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil.
JAMA cardiology
|December 6, 2023
概括
心力衰竭 (HF) 住院后的密集远程监测改善了患者的自我护理,但没有降低NT-proBNP水平或临床事件. 这种策略是可行的,并且得到了患者的良好接受.
科学领域:
- 心脏病学 心脏病学
- 数字健康数字健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心力衰竭 (HF) 的再入院是一个重大的医疗保健挑战.
- 确定有效的策略来管理住院后的患者至关重要.
研究的目的:
- 评估密集远程监控战略的可行性和有效性.
- 评估其在HF住院后的脆弱时期的影响.
主要方法:
- 一项随机临床试验,涉及巴西30家高频率诊所的699名患者.
- 患者接受了远程监控 (每日短信,自动警报) 或标准护理.
- 主要终点:180天后N端脑前性尿素 (NT-proBNP) 的变化;次要:复合临床结果.
主要成果:
- 远程监控是可行的,并且得到了很好的接受 (净促进者得分78.5).
- 与标准护理相比,远程监控组的高频自我护理得分显著改善.
- 没有观察到NT-proBNP水平或组间复合临床结果的显著差异.
结论:
- 密集的远程监控是一种可行和可接受的方法,在HF住院后.
- 虽然它增强了患者的自我护理,但在本试验中,它没有在减少NT-proBNP或重大不良事件方面显示出显著的临床益处.
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