[COPD患者使用电子健康平台e-Vita对疾病特定生活质量的影响]。

Esther Talboom-Kamp, Marije Holstege, Niels Chavannes, Marise Kasteleyn
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引用次数: 0

摘要

背景:慢性阻塞性肺疾病(COPD)的综合疾病管理与自我管理可有效改善临床预后。电子健康可以提高患者的参与度,使他们能够接受并保持更健康的生活方式。尽管在不同的环境下,电子健康对生活质量(QoL)的影响证据不一。目的:e- vita -COPD研究的主要目的是调查使用eHealth患者平台对COPD患者疾病特异性生活质量的影响。方法:我们评估了电子健康平台对慢性阻塞性肺病临床问卷(CCQ)测量的疾病特异性生活质量的影响,包括症状、功能状态和精神状态的亚量表。采用中断时间序列(ITS)设计,在多个时间点采集CCQ数据。采用多水平线性回归模型比较电子健康干预前后CCQ的趋势。结果:在742名受邀COPD患者中,244人签署了知情同意书。在分析中,我们只纳入了实际使用电子健康平台的患者(n = 123)。干预前ccq症状减少0.20%,干预后减少0.27%;差异有统计学意义(P=0.027)。干预前CCQ-mental下降0.97%,干预后CCQ-mental上升0.017%;差异有统计学意义(P= 0.01)。干预前后CCQ斜率(P=0,12)和CCQ函数斜率(P=0,11)无显著差异。结论:e-Vita eHealth平台对COPD患者的ccq症状有潜在的有益影响,但对功能状态没有影响。ccq -心理状态在干预后保持稳定,但与电子健康平台启动前的改善情况相比,这是一种恶化。综上所述,本研究表明,引入COPD平台后,患者症状减少,但同时精神状态略有恶化。因此,卫生保健提供者应该意识到,在引入电子卫生干预以支持自我管理后,尽管症状有所改善,但焦虑和抑郁可能会略有增加。
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[Effects of use of an eHealth platform e-Vita for COPD patients on disease specific quality of life domains].

Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients' involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings.

Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients.

Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention.

Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention.

Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.

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