| Chapter Ⅰ Feasibility of telemedicine in follow-up management of patients with chronic heart failureObjective:To evaluate the feasibility of intelligent application(APP)combined with video remote follow-up for the management of patients with chronic heart failure(CHF)Methods:From February 2015 to July 2015,100 patients with chronic heart failure were recruited in the outpatient clinic of Subei People’s Hospital of Jiangsu province.They were educated on self-management of heart failure,trained patients and their family members to use follow-up APP skillfully.They were required to upload symptoms,signs,medication and auxiliary examination results monthly.Follow-up doctors followed up patients through follow-up doctor APP.Follow-up and medical advice were given.The feedback of patients and their families on the use of follow-up patients’APP was counted.At the same time,every Wednesday afternoon,doctors and patients will be arranged for remote video consultation,online diagnosis and treatment,and give advice on diagnosis and treatment.During the follow-up period and before and after the follow-up,the quality of life of the patients was assessed.After the follow-up,the satisfaction of the patients with remote follow-up management was investigated by self-made questionnaires from the research team.To evaluate the feasibility of telemedicine in follow-up management of patients with chronic heart failure.Results:The use rate of intelligent APP in CHF follow-up patients was 98%,and the effective utilization rate was 93.4%.After 6 months of follow-up,the New York Heart Association(NYHA)cardiac function grade was improved from baseline,and the MLHFQ score(57.7 ± 8.9)was statistically significant compared with baseline(61.7 ± 9.6).The patient’s satisfaction with this management model was 93.9%.Conclusion:The use rate of intelligent APP is high among patients and their families.Intelligent APP combined with video remote follow-up can effectively improve patients’cardiac function and quality of life,and patients are satisfied with this management model.It is feasible to apply intelligent APP combined with video remote follow-up to follow-up management of CHF patients.Chapter Ⅱ Value of telemedicine in follow-up management of patients with chronic heart failureObjective:To explore the value of intelligent APP combined with video remote follow-up in follow-up management of CHF patients.Methods:From August 2015 to July 2016,200 CHF patients were recruited in the outpatient clinic of Subei People’s Hospital of Jiangsu province.According to the random number table method,the patients were divided into two groups.The strengthened remote group and the platform management group were strengthened.The strengthened remote group visited the clinic every February-April,at least once a month.The platform management group visited the outpatient clinic every 1-2 months,and non-randomly selected the sex,platform management group and the above random group.One hundred patients with chronic heart failure who were followed up irregularly and matched by age and other general conditions served as control group.The follow-up time was at least 12 months.The 6 minutes walk distance,LVEF and N-terminal B-type natriuretic peptide(NT-proBNP)were compared among the three groups.Results:After 12 months of follow-up,compared with the control group,the indicators of 6MWD,LVEF and NT-proBNP in the strengthened remote group and platform management group had significant differences.Compared with the platform management group,the indicators of 6MWD,LVEF and NT-proBNP in the strengthened remote group had no statistical significance.Conclusion:Intelligent APP combined with video remote follow-up for CHF patients is a precise follow-up management mode,which is conducive to improving the cardiac function of CHF patients. |
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