碳和旅行成本的降低从远程药物定位的高级心力衰竭:一个随机对照试验的二次分析随机对照试验
Michael D Elfassy1, Kyle Runeckles1, Nicole Simms2
1Peter Munk Cardiac Centre (PMCC), University Health Network, University of Toronto.
The Canadian journal of cardiology
|July 31, 2025
概括
通过减少喷射率 (HFrEF) 的心力衰竭的远程患者管理,可以显著减少旅行,碳排放和成本. 这种方法优化了指导方针导向医学治疗 (GDMT),比常规护理更快,更有效.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 环境健康 环境健康
背景情况:
- 优化心力衰竭与减少喷射率 (HFrEF) 的指导指导医学治疗 (GDMT) 通常涉及频繁的面对面访问,增加患者负担和医疗保健的碳足迹.
- 远程患者管理 (RPM) 为HFrEF护理提供了一个潜在的可持续和具有成本效益的替代方案,旨在保持高质量的治疗.
研究的目的:
- 在HFrEF中评估RPM对GDMT定位的环境和财务影响.
- 为了比较远程GDMT定位与通常护理在实现治疗目标方面的有效性.
主要方法:
- 对Medly Titrate随机对照试验的二次分析.
- 利用CASCADES虚拟护理碳计算工具估计碳排放和患者旅行费用.
- 采用1:1近邻匹配和引导分析,以确保可靠的比较.
主要成果:
- 远程GDMT定位导致患者实现目标的比例更高 (98%vs85%) 和更快的定位 (62天更早).
- 在偏远群体中,总碳排放 (8.50),旅行距离 (-41,923.53公里) 和旅行费用 (-12,258.78加元) 显著减少.
- 远程组旅行的中位数为140公里,而通常护理的213公里.
结论:
- 远程GDMT定位是管理HFrEF,减少环境影响和医疗保健成本的有效策略.
- 这项研究首次使用专门的碳计算器量化了与远程高频药物定位相关的环境和财务节约.
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