远程监控对在家中非侵入性通风过程中学率的影响:使用家庭护理提供者数据库的回顾性研究
Raphael Le Mao1,2,3, Christophe Gut Gobert4,2, Joelle B Texereau5,6
1Department of Internal Medicine and Pneumology, La Cavale Blanche Hospital, CHU de Brest, Brest, France raphael.lemao@gmail.com.
BMJ open
|October 4, 2024
概括
与标准护理相比,家庭非侵入性通风 (NIV) 的远程监测 (TM) 在一年内显著减少了治疗中断. 这种方法还改善了患者的遵从性和在治疗慢性呼吸衰竭时的泄漏控制.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 医疗技术 医疗技术 医学技术
- 医疗信息学 医疗信息学
背景情况:
- 家庭非侵入性通风 (NIV) 疗法设置通常由远程监控 (TM) 促进.
- 在NIV患者中,TM对治疗坚持,学率和泄漏管理的长期影响仍然不清楚.
- 评估TM对减少治疗中止的影响对于优化患者结果至关重要.
研究的目的:
- 评估与远程支持相结合的远程监控 (TM) 是否降低了家庭非侵入性通风治疗 (NIV) 的学率.
- 为了比较使用TM和非远程监测 (NTM) 途径的患者之间的1年中断率.
- 评估TM对治疗遵守和泄漏控制的影响.
主要方法:
- 追溯队列研究涉及659名患有慢性呼吸衰竭的成年患者,其发病原因是夜间NIV.
- 患者被分为一个TM组 (≥80%的TM随访) 和一个NTM组 (0-10天的TM).
- 主要结局是1年内NIV退学率;次要结局包括合规性和泄漏控制.
主要成果:
- 与NTM组相比,在1年内停止NIV治疗的TM组患者显著减少 (13%) (34%;p<0.001).
- 经过调整后的分析显示,TM与降低67%的学风险相关 (HR 0.33; p<0.001).
- 在多个随访点上,TM组表现出更好的NIV使用 (>4小时/天) 和泄漏控制.
结论:
- 远程监测,当由家庭护理提供者支持时,显著降低了家庭NIV治疗的1年学率.
- TM与改善患者遵守和更好地管理通风泄漏有关.
- 这些发现支持将TM纳入NIV患者的标准后续护理.
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