移动医疗APP对门诊2型糖尿病患者治疗效果评价

韩辰宇; 钱进; 金海英; 叶晓梅; 王萍; 张敏

doi:10.19428/j.cnki.sjpm.2019.18994

移动医疗APP对门诊2型糖尿病患者治疗效果评价

Effect evaluation on mobile medical APP for treatment of outpatients with type 2 diabetes

摘要

摘要:
目的评估移动医疗应用程序(APP)对门诊2型糖尿病患者的治疗效果。
方法选取在复旦大学附属中山医院青浦分院内分泌科门诊就诊的2型糖尿病(T2DM)患者114名为观察对象，随机分为移动医疗组(干预组)和传统面对面随访组(对照组)。两组患者均分发电子血糖仪、电子血压计和电子体重秤各一台。干预组采用远程医疗系统进行干预，对照组采用传统的门诊随访。观察时间均为6个月。
结果研究结束时，干预组失访1人、退出3人、完成研究53人；对照组失访2人、完成研究55人。干预组患者糖化血红蛋白(HbA1c)＜7.0%的比例高于对照组(45%与29%，P＜0.001)，两组患者HbA1c水平差异有统计学意义(P＝0.032)。与对照组相比，干预组患者在BMI、收缩压、三酰甘油和丙氨酸氨基转移酶的控制上明显优于对照组(P=0.026、P=0.043、P=0.001、P=0.048)，其他临床指标差异均无统计学意义。干预组患者自我监测血糖、血压和体重的次数均明显高于对照组(P=0.009、P=0.033、P=0.045)。干预组患者低血糖的发生次数明显低于对照组(2.0%与6.4%，P=0.044)。干预组和对照组患者的门诊随访次数分别为53人次和87人次(P=0.031)，而急诊+住院次数在两组之间未发现明显差异。
结论移动医疗APP作为健康教育和行为支持的工具，可有助于改善院外T2DM患者的代谢指标，有益于医疗资源的有效利用。

Abstract:
ObjectiveThe study aims to assess the effectiveness of mobile medical App in the management of outpatients with type 2 diabetes(T2DM).
MethodsA total of 114 patients with T2DM were randomly divided into mobile medical group (trial group) and traditional face-to-face follow-up group (control group).Every patient received an electronic blood glucose meter, an electronic sphygmomanometer and an electronic weight scale.Patients in the trial group were treated with a telemedicine system and patients in the control group with a conventional outpatient follow-up model.The study was conducted for 6 months.
ResultsA total of 114 patients were eligible for inclusion and participated in the study voluntarily.At the end of the study, with 1 patient lost and 3 patients withdrawing from the study, 53 patients completed the study in the trial group, while there were 2 patients lost and 55 patients completing the study in the control group. At the end of the study (6 months), the ratio of HbA1c < 7.0% in the trial group was higher than that in the control group (45% vs 29%, P < 0.001), and the difference in HbA1c levels between the two groups was obvious(P=0.032).Compared with the control group, the trial group had better control of BMI, SBP, TG and ALT (P=0.026, P=0.043, P=0.001, P=0.048).Other clinical indicators had no significant difference. The numbers of self-monitoring blood glucose, blood pressure and body weight were higher in the trial group than those in the control group (P=0.009, P=0.033, P=0.045).In terms of safety, the numbers of hypoglycemia in the trial group was lower than those in the control group (2.0% vs 6.4%, P=0.044). A lower number of specialist visits was reported in the telemedicine group (53 vs 87, P=0.031), while the number of emergency and hospitalizations did not show significant differences between the two groups.
ConclusionThis study confirms that telemedicine systems can improve the awareness of self-management in patients with T2DM and enhances the communication between doctors and patients.

HTML全文

参考文献(13)

施引文献

资源附件(0)