手机应用支持对脑卒中患者服药依从性影响的Meta分析

Meta-analysis of effects of mobile phone application support on medication compliance of stroke patients

目的探讨手机应用支持对脑卒中患者服药依从性的影响。方法应用计算机检索CNKI、万方、维普、PubMed、Cochrane Library、Embase等数据库,选取有关手机应用支持对脑卒中患者服药依从性影响的随机对照试验研究。研究者按照纳入和排除标准筛选文献、提取资料、质量评价,采用RevMan 5.3软件进行Meta分析,检索时间为建库至2019年8月31日。结果共纳入10篇RCT。在提高服药依从性方面,亚组分析结果显示,手机应用支持能够提高脑卒中患者服药依从性[SMD=0.70,95%CI(0.34~1.06),P<0.00001]。在血压控制方面,手机应用支持对收缩压的控制有效果[MD=-8.11,95%CI(-15.82~-0.40),P=0.04],对舒张压控制无统计学意义(P=0.34)。结论手机应用支持在提高脑卒中患者服药依从性及控制收缩压方面效果明显,能有效控制血压波动,改善疾病预后,但还不确定是否能有效控制舒张压,仍需大量的多中心、大样本RCT来证实其效果。

Objective To explore the effect of mobile phone application support on medication compliance of stroke patients.Methods China National Knowledge Infrastructure(CNKI),Wanfang,VIP Database,PubMed,Cochrane Library,Embase were searched by computer to select randomized controlled trial studies on the effect of mobile application support on medication compliance of stroke patients.According to the inclusion and exclusion criteria,researchers selected the literature,extracted data and evaluated the quality.RevMan 5.3 software was used for Meta-analysis and the retrieval time was from the establishment of databases until August 31,2019.Results A total of 10 randomized controlled trials(RCTs)were included.In terms of improving medication compliance,the results of subgroup analysis showed that mobile phone application support could improve medication compliance of stroke patients[SMD=0.70,95%CI(0.34-1.06),P<0.00001].In terms of blood pressure control,mobile phone application support was effective in controlling systolic blood pressure[MD=-8.11,95%CI(-15.82--0.40),P=0.04],but there was no statistically significant difference in its effect on diastolic blood pressure control(P=0.34).Conclusions Mobile phone application support is effective in improving medication compliance and controlling systolic blood pressure in stroke patients.It can effectively control blood pressure fluctuations and improve prognosis of the disease.However,it is still uncertain whether diastolic blood pressure can be effectively controlled and a large number of multi-center,large-sample clinical randomized controlled trials are still needed to confirm its effects.