使用远程患者管理平台在优化心力衰竭患者指南导向医疗疗的效果:随机对照试验
Darshan H Brahmbhatt1, Heather J Ross2, Mary O'Sullivan3
1Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
JACC. Heart failure
|April 3, 2024
概括
远程药物定位显著改善了心力衰竭患者的指导指导医学治疗 (GDMT) 完成率. 这种远程监控方法被证明是有效的,与常规护理相比,减少了住院治疗.
科学领域:
- 心脏病学 心脏病学
- 数字健康数字健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 在心力衰竭中,指南导向医学疗法 (GDMT) 尚未得到充分利用,导致心力衰竭减少喷射率 (HFrEF),导致发病率和死亡率增加.
- 优化GDMT对于改善HFrEF患者的治疗结果至关重要.
研究的目的:
- 为了评估使用Medly Titrate远程监测程序远程药物定位的有效性,与HFrEF患者的常规护理 (UC) 相比.
- 评估远程定位是否改善GDMT完成率并影响临床结果.
主要方法:
- 一个开放标签,随机对照试验,涉及108名HFrEF患者.
- 患者被随机分配到通过Medly计划 (n=56) 或UC (n=52) 进行远程GDMT定位.
- 主要结局是6个月完成GDMT定位;次要结局包括诊所访问,定位时间和医疗保健利用率.
主要成果:
- 在远程定位组 (82.1%) 与UC (53.8%) (P=0.001) 中,GDMT定位完成率显著更高.
- 远程定位需要更少的面对面和虚拟诊所访问,以及更短的时间来优化药物治疗.
- 在远程定位组 (IRR:0.55;P=0.042) 中,所有原因的住院住院减少,紧急访问没有显著差异.
结论:
- 对于HFrEF,GDMT的远程定位是有效的,安全的和可行的,增加了达到目标剂量的患者比例.
- 远程监测有助于及时优化药物治疗,从而改善临床结果和减少住院治疗.
- 在Medly Titrate研究表明远程监控在管理HFrEF药物治疗的价值.
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