互联网+手机视频督导管理结核病患者效果评价

Effect of video observed therapy for tuberculosis patients’ management by internet and mobile phones

目的评价互联网+手机视频督导对结核病患者的治疗管理效果。方法采用社区干预研究的方法,选取深圳市龙华区慢性病防治中心2017年1月1日至2018年6月30日登记治疗的肺结核患者为研究对象,共纳入1174例。收集并分析不同特征患者在视频督导系统上传服药记录情况。结果研究期间,研究机构共登记结核病患者1301例,其中1174例患者接受互联网+手机视频督导,研究对象纳入率为90.2%(1174/1301);研究对象共计服药次数为26.56万人次,通过系统上传服药信息19.64万人次,服药信息获得率73.9%。服药信息获得率<50%、50%~、90%~、100%的患者分别为283例(24.1%,283/1174)、256例(21.8%,256/1174)、538例(45.8%,538/1174)、97例(8.3%,97/1174)。患者规则上传服药信息行为与性别、年龄有关,男性患者不规则上传服药信息的风险是女性的1.456(1.130~1.876)倍;≥40岁年龄组不规则上传服药信息的风险是<40岁年龄组的1.430(1.130~1.811)倍。结论大部分肺结核患者能接受并按要求配合互联网+手机视频督导;需要加强对男性、≥40岁年龄组人群的培训和指导。

Objective To evaluate the effect of video observed therapy(VOT)for tuberculosis patients’ management by internet and mobile phones.Methods By aprospective cohort study,1174 pulmonary tuberculosis patients were registered and recruited for VOT management in Shenzhen Longhua Center for Chronic Disease Control(CCDC),from January 1 st,2017 to June 30 th,2018.The medicine records in system of VOT was selected and analyzed. Results During research period,1301 patients were registered in Longhua CCDC,90.2%(1174/1301)of the patients joined VOT management.Total medication times of patients in the study were 265.6 thousand,and the medication times uploaded in the system were 196.4 thousand(73.9%,196 400/265 600).The number of patients whose uploaded medication rates in VOT system were divided into under 50%,50%-,90%-,100% were 283(24.1%,283/1174),256(21.8%,256/1174),538(45.8%,538/1174),97(8.3%,97/1174),respectively.The upload medication rates were significance different in the different groups of age and gender.The risk without upload medication regularly in male was higher 1.456(1.130-1.876)than in female;the risk in over40 age was higher 1.430(1.130-1.811)than in under 40 age group.Conclusion Most pulmonary tuberculosis patients can accept and comply with VOT supervision as required.Additional training and guidance should be given to the age over 40 age or male patients undergoing VOT surveillance.