对心力衰竭患者疾病管理计划的干预措施的有效性:系统性审查和元分析
Hui-Yi Yap1, Po-Ming Ku1, Wen-Tsung Huang2
1From the Department of Cardiology, Chi Mei Medical Center, Tainan City, Taiwan, R.O.C.
Cardiology in review
|December 19, 2024
概括
疾病管理计划 (DMP) 显著改善心力衰竭 (HF) 恢复. 这些计划提高了运动能力,体力活动和生活质量,同时减少了HF患者的住院和死亡率.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 基于证据的医学基于证据的医学.
背景情况:
- 由于人口老龄化和风险因素增加,心力衰竭 (HF) 的全球流行率不断上升.
- 心力衰竭疾病管理计划 (DMP) 对于管理心力衰竭和优化患者结果至关重要.
- 需要进行系统审查和元分析来评估HF事件后的DMP有效性.
研究的目的:
- 系统地审查和元分析疾病管理计划 (DMP) 对心力衰竭 (HF) 事件后患者的有效性.
- 评估DMP对关键患者结果的影响,包括运动能力,身体活动,情绪健康和生活质量.
- 评估DMPs对住院,再住院和与心力衰竭相关的死亡率的影响.
主要方法:
- 随机对照试验的系统审查和元分析.
- 搜索了五个主要的电子数据库 (Embase,PubMed,Web of Science,Scopus,CINAHL) 在2023年12月之前发表的研究.
- 包括12篇文章,共3844名患者在HF事件后的患者中比较DMP与安慰剂.
主要成果:
- 参与DMP干预组的患者在运动能力方面显著改善 (MD 53.33,95% CI 43.40-67.26;P < 0.00001).
- DMPs导致身体活动显著改善 (MD -5.76,95% CI -8.86至 -2.66;P = 0.0003),情绪健康 (MD -2.32,95% CI -4.39至 -0.25;P = 0.03),以及生活质量 (MD -9.13,95% CI -16.79至 -1.48;P = 0.02).
- 与DMP组相比,对照组的住院病例 (P = 0.0002),再入院病例 (P = 0.00001) 和与HF相关的死亡率 (P = 0.003) 显著增加.
结论:
- 疾病管理计划 (DMP) 对从心力衰竭 (HF) 事件中恢复过来的患者产生了积极的影响.
- DMP有效地提高关键健康指标,如运动能力,身体活动,情绪健康和生活质量.
- 在心力衰竭患者群体中,DMP显著降低了不良事件,包括住院,再住院和死亡率.
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