文献类型：期刊文献

英文题名：Effects of home-based telemedicine and mHealth interventions on blood pressure in stroke patients: a systematic evaluation and meta-analysis of randomized controlled trials

作者：Liang, Qian[1];Tao, Yuan[1];He, JunFang[2];Bo, Yan[4];Xu, LiangLiang[2];Zhao, Fei[3]

第一作者：Liang, Qian

通信作者：Zhao, F[1]

机构：[1]Gansu Univ Chinese Med, Sch Nursing, Lanzhou, Peoples R China;[2]Gansu Univ Tradit Chinese Med, Affiliated Hosp, Lanzhou, Peoples R China;[3]Northwest Minzu Univ, Med Coll, Key Lab Environm Ecol & Populat Hlth Northwest Min, Lanzhou, Peoples R China;[4]Northwest Minzu Univ, Fac Med, Lanzhou, Peoples R China

第一机构：甘肃中医药大学护理学院

通信机构：[1]corresponding author), Northwest Minzu Univ, Med Coll, Key Lab Environm Ecol & Populat Hlth Northwest Min, Lanzhou, Peoples R China.

年份：2024

卷号：33

期号：11

外文期刊名：JOURNAL OF STROKE & CEREBROVASCULAR DISEASES

收录：;Scopus(收录号：2-s2.0-85202581092);WOS:【SCI-EXPANDED(收录号:WOS:001316896600001)】；

语种：英文

外文关键词：Stroke; Telemedicine; mHealth; Systolic blood pressure; Diastolic blood pressure; Management; Medication adherence

摘要：Background: Stroke is a common cerebrovascular disease. Elevated blood pressure is the most significant manageable factor for both initial and recurrent strokes. Despite the potential benefits of telemedicine and mobile health technology (mHealth) in managing blood pressure among stroke patients, there remains skepticism. Objectives: This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effectiveness of telemedicine and mHealth interventions in managing blood pressure in stroke patients. Methods: We identified randomized controlled trials (RCTs) evaluating telemedicine and mHealth technology interventions for blood pressure in patients with stroke or transient ischemic attack (TIA) from the inception date of each database up to January 2, 2024 by systematic searches of the PubMed, EMBASE, Web of Science, and Cochrane Library databases. The Cochrane Risk of Bias tool (ROB 2.0) was used to evaluate study quality. Sources of heterogeneity were explored through Meta-regression, subgroup analyses, sensitivity analyses and publication bias assessment. Meta-analysis was performed using R 4.2.2 statistical software. Results: A total of 13 randomized controlled trials with 3803 participants were included. The meta-analysis found that telemedicine and mHealth improved control of both systolic [MD = -4.37, 95 % CI (-5.50, -3.24), I-2 = 43 %, P<0.00001] and diastolic blood pressures [MD = -1.72, 95 % CI (-2.45, -0.98), I-2 = 0 %, P<0.00001] in stroke patients compared to the conventional care group. Stroke patients who received telemedicine and mHealth interventions showed improved medication adherence than usual care [SMD=0.52, 95 % CI (0.03, 1.00), I-2 = 90 %, P<0.00001]. Meta-regression and subgroup analyses identified several key factors influencing systolic and diastolic blood pressure control in stroke patients, including whether stroke patients have hypertension, the specific forms of telemedicine and mHealth interventions employed, the duration of these interventions, and the frequency of intervention intervals. Conclusions: Overall, telemedicine and mHealth reduced stroke patients' systolic blood pressure by an average of 4.37 mm Hg and diastolic blood pressure by an average of 1.72 mm Hg and improved medication adherence compared with usual care. As an emerging medical model, telemedicine and mHealth intervention create a good prospect for the management of blood pressure in stroke patients in the future.