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联网远程疾病管理对RA患者治疗依从性和疾病活动度的影响
罗家昂,邹晋梅,杨静,刘毅,董建玲,张羽,肖纯玥
0
(绵阳市中心医院风湿免疫科;四川大学华西医院风湿免疫科)
摘要:
【摘要】 目的 探讨互联网远程疾病管理对类风湿关节炎(RA)患者治疗依从性和疾病活动度的影响。 方法 选取2017年6月~2018年2月在绵阳市中心医院风湿免疫科住院及门诊就诊的RA患者250例行前瞻性研究,将患者随机分为远程管理组和对照组,通过入选标准和排除标准,对照组最终纳入104例,远程管理组最终纳入102例。确定治疗方案后对治疗方案不做重大调整,随诊6个月后比较两组患者治疗依从性及DAS28评分。 结果 DAS-28评分与风湿病治疗依从性CQR评分(Compliance questionnairerheumatology,CQR)呈负相关性(P<0.001),且远程管理组治疗依从性CQR评分显著高于对照组(P<0.001)。远程管理组遵从专科医师建议及服药医嘱的患者较对照组更多(P<0.05)。采取特殊的方式记录和提醒自己服药及能够接受部分药物副作用的患者比例较对照组更高(P<0.05),外出忘记带药和服药的情况较对照组更少(P<0.05)。治疗后远程管理组病情好转比例较对照组更高(P<0.05),而愿意选择其他治疗方法替代风湿病专科医师治疗的患者较对照组更少(P<0.05)。两组患者治疗后DAS-28评分均较治疗前显著降低(P<0.05),但远程管理组患者DAS28评分较对照组更低(P<0.001),整体达标率更高(P<0.001)。 结论 基于互联网的远程管理可以提高RA患者治疗依从性,降低患者疾病活动度,提高治疗达标率。
关键词:  类风湿关节炎  互联网  远程管理  治疗依从性  疾病活动度  治疗达标率
DOI:
基金项目:四川省科技计划项目;川北医学院2019年度四川省基层卫生事业发展研究中心资助项目
Effects of Internet based remote management on treatment compliance and disease activity in patients with rheumatoid arthritis
LUO Jiaang,ZOU Jinmei,YANG Jing,LIU Yi,DONG Jianling,ZHANG Yu,XIAO Chunyue
(Department of Rheumatology and Immunology, Central Hospital of Mianyang;Department of Rheumatology and Immunology, West China Hospital, Sichuan University)
Abstract:
【Abstract】 Objective This research was to explore the effects of internetbased remote management on treatment compliance and disease activity in patients with rheumatoid arthritis (RA). Method RA patients were randomly divided into remote management group and conventional management group. Once the treatment plan was determined, no major adjustment was made to it,and after 6 months of followup, DAS-28 score and CQR score of the two groups were compared. Results DAS28 score was negatively correlated with CQR score(R2=0.546,P=0.000), and CQR score of remote management group was significantly higher(78.8±12.8 vs 68.1±13.0,t=5.573,P=0.000). Compared with the control group, the remote management group had more patients who followed the advice of a specialist, and there are more patients who took special measures to record and remind themselves to take their medicine, and fewer patients who forgot to take their medicine when they went out. The remote management group had a higher percentage of improvement after treatment, and fewer patients were willing to turn to other treatments instead of the treatment of a rheumatologist. DAS28 score of both groups are showing a significant decrease, and the remote management group has a lower DAS28 score(2.9±0.89 vs 3.25±1.12,P=0.015) and a higher compliance rate(71.6% vs 57.7%,P=0.037)than the other group. Conclusion Internetbased remote management can improve the treatment compliance and reduce the disease activity of RA patients,consequently improving the compliance rate.
Key words:  Rheumatoid Arthritis  Internet  Remote management  Treatment compliance  Disease activity  Treatment compliance rate

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