■远程健康干预有可能改善慢性阻塞性肺疾病(COPD)患者的健康状况。然而,远程医疗对急性加重和再入院的确切影响仍无定论.对远程医疗在COPD护理中的有效性缺乏了解可能是由于不清楚哪些变量与入学率和辍学率最密切相关。
■在远程健康研究中,我们的目的是:(1)估计与试验相关的变量与入学率和辍学率相关的程度,并确定退学原因;(2)估计患者相关变量和干预相关变量与退学率的关联程度;(3)估计入学率和退学率对效应大小的影响;(4)估计试验相关、患者相关,以及干预相关变量对效应大小的影响。
■使用四个电子数据库进行了系统的文献检索。两名独立审稿人筛选了所有检索到的标题,根据纳入标准进行摘要和全文,并提取数据。进行了随机效应荟萃回归分析,以估计总体入学率和辍学率,并估计了不同变量对入学率的影响,辍学率,和影响的大小在研究纳入审查。
■共确定了56项研究,包括7530名参与者。估计入学率和辍学率分别为50.3%和14.9%,分别。试验相关变量影响入学率和辍学率,包括RCT设计和招聘。与患者相关的变量,包括年龄和疾病的严重程度,和干预相关变量,包括干预的组成部分和交付方式,影响辍学率。低辍学率的研究具有0.23的更大效果。退出干预的主要报告原因与死亡(21%)有关,其次是失去随访(14%)。
■试用,病人,研究发现干预相关变量会影响入学率和辍学率。这将有助于计划和开发一种更具吸引力的远程医疗干预措施,患者可以轻松接受并融入他们的日常生活。
■国际前瞻性系统评价登记册(PROSPERO);ID:CRD42017078541。
UNASSIGNED: Telehealth interventions have the potential of improving health outcomes for individuals with chronic obstructive pulmonary disease (COPD). However, the precise impact of telehealth on exacerbation and hospital readmissions remains inconclusive. This lack of knowledge on the effectiveness of telehealth for COPD care might be due to lack of clarity regarding which variables are most strongly associated with enrolment and dropout rates.
UNASSIGNED: Among individuals with COPD in telehealth studies, we aimed to: (1) estimate the extent to which trial-related variables are associated with enrolment and dropout rates, and identify reasons for dropouts; (2) estimate the extent to which patients-related and intervention-related variables are associated with dropout rates; (3) estimate the effect of enrolment rate and dropout rate on effect size; (4) estimate the effect of trial-related, patient-related, and intervention-related variables on effect size.
UNASSIGNED: A systematic literature search was conducted using four electronic databases. Two independent reviewers screened all retrieved titles, abstracts and full texts according to the inclusion criteria and extracted the data. A random-effect meta-regression analysis was conducted to estimate the overall enrolment and dropout rates, and estimated the different variables\' effects on the enrolment rate, dropout rate, and effect sizes in the studies included in the
review.
UNASSIGNED: A total of 56 studies comprising 7530 participants were identified. The estimated enrolment and dropout rates were 50.3 % and 14.9 %, respectively. Trial-related variables influence enrollment and dropout rates, including RCT designs and the recruitments. The patient-related variables, including age and severity of the disease, and intervention-related variables, including the components of the intervention and mode of delivery, influence dropout rates. Studies with low dropout rates had a bigger effect size by 0.23. The main reported reasons for dropping out of the intervention were related to death (21 %) followed by lost to follow-up (14 %).
UNASSIGNED: Trial, patient, and intervention-related variables were found to influence the enrolment and dropout rates. This would help plan and develop a more appealing telehealth intervention that patients can easily accept and incorporate into their everyday lives.
UNASSIGNED: International Prospective Register of Systematic Reviews (PROSPERO); ID: CRD42017078541.