远程医疗在高血压病人自我管理中应用效果评价的Meta分析

目的:评价远程医疗对高血压病人自我管理血压控制效果的影响。方法:计算机检索PubMed、EMbase、the Cochrane Library、中国知网(CNKI)、维普(VIP)、中国生物医学文献服务系统(SinoMed)和万方数据库,收集与常规高血压管理模式相比,以远程医疗为基础的高血压管理模式对高血压控制效果的随机对照试验。由2名研究者独立检索、筛选文献,提取数据及质量评价后利用STATA 12.0软件进行录入和统计分析。结果:纳入文献14篇,总样本量5526例。Meta分析结果显示,远程医疗干预组较常规护理干预对照组显著降低了高血压病人的收缩压[WMD=-5.93,95%CI(-8.51,-3.36),P<0.001]、舒张压[WMD=-3.50,95%CI(-5.28,-1.72),P<0.001]和增加了血压控制达标率[RR=1.30,95%CI(1.11,1.52),P<0.001]。亚组分析得出,随访时间越长(≥12个月)以及使用APP的远程医疗干预方式,降压效应越明显。结论:现有证据表明,远程医疗干预有利于高血压病人的血压管理和控制,为持续性血压监测和病人教育提供了新的方法。

Effect evaluation of telemedicine intervention in self-management of patients with hypertension:a Meta-analysis

Objective:To evaluate the effect of telemedicine on blood pressure control of patients with hypertension.Methods:Randomized controlled trials on the effect of telemedicine based hypertension management mode on hypertension control compared with conventional hypertension management mode,were searched from PubMed,EMbase,the Cochrane Library,CNKI,VIP,SinoMed and WanFang databases.Searching,sereening,extraction of data and evaluation of the quality of the literature were conducted independently by two researchers.Then,Stata 12.0 software was used for entry and statistical analysis.Results:A total of fourteen articles were included,involving 5526 cases.Meta-analysis results showed that telemedicine intervention significantly reduced systolic blood pressure[WMD=-5.93,95%CI(-8.51,-3.36),P<0.001],diastolic blood pressure[WMD=-3.50,95%CI(-5.28,-1.72),P<0.001]and increased the standard rate of blood pressure control[RR=1.30,95%CI(1.11,1.52),P<0.001].And subgroup analysis showed that the longer follow-up time(≥12 months)and the APP telemedicine intervention,could be helpful in reducing the blood presure.Conclusion:Current evidence shows that telemedicine intervention is conducive to blood pressure management and control,which provide a new method for continuous blood pressure monitoring and patient education.