| Background Chronic heart failure is the end stage of the development of various heart diseases.It has the characteristics of high morbidity,high readmission rate and high mortality,and brings huge economic burden to the patients' families and the whole society.The emergence of telemedicine has opened a new chapter in the disease management of patients with chronic diseases.Therefore,this study used the chronic disease management platform to explore the feasibility of remote management for outpatient patients with chronic heart failure,as well as the impact of remote management on patients' medication compliance and self-management.Methods During the period from November 1,2016 to January 31,2017,patients with chronic heart failure were enrolled in the outpatient clinic.Researchers integrated patients' data through the hospital information system,managed patients with remote follow-up for 6 months through modern Internet information tools and remote ECG monitoring equipment.Video follow-up was arranged in the 1st,2nd,4th and 5th months,and outpatient follow-up was arranged in the 3rd and 6th months to dynamically evaluate the patients' condition and provide individualized treatment.After the follow-up,the safety and feasibility of the remote management model in clinical application were evaluated through the analysis of patients' follow-upcompletion and satisfaction survey.By analyzing the differences of Morisky Medication Adherence Scale and 9-item European heart failure self-care behavior scale before and after the management,the influence of remote management on drug compliance and self-management ability of patients and its influencing factors were further evaluated.Result A total of 64 patients were enrolled,and 62 patients(96.9%)completed the6-month follow-up.The planned 372 follow-up visits were 301(80.9%),and32(72.7%)unfinished video follow-up visits and 17(55.6%)unfinished outpatient follow-up visits were related to the lack of assistance from family members.There were 76 unexpected follow-up visits,47 unexpected video follow-up visits,and 44events(93.6%)among them were due to doctors' failure to deal with it in time,and31 events didn't require outpatient treatments after evaluation,including 21 unexpected follow-up visits(45.7%)caused by psychological factors.At the end of follow-up,54 patients(87.1%)were very satisfied or satisfied with the treatment mode,and 8 patients(12.9%)were generally satisfied with the medical mode,and none of the patients were dissatisfied with the medical mode.After follow-up,the patient's compliance with medication improved(p<0.05).At baseline,patients' compliance with medication is related to family composition and educational level(p<0.05),but there is no difference between people over 60 or under 60 years of age(p=0.864).However,there were differences in the distribution of compliance scores between the two groups(p<0.05).Self-care behavior in patients with an average of 24.47±3.72,after the remote management,average self-care behavior inpatients with an average of 22.25±2.61,the difference is statistically significant(p<0.05).Conclusion It is feasible to establish a remote management platform based on the hospital information system and establish a remote follow-up management model for patients with chronic heart failure by using modern Internet information tools and remote monitoring equipment,which is conducive to improving the efficiency of medical resource utilization and alleviating the shortage of medical resources.The participation of family members plays an important role in improving the efficiency of remote follow-up management.Under the management mode of this study,patients' overall drug compliance and self-management ability were improved. |
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