收稿日期: 2021-09-18
网络出版日期: 2022-09-20
A systematic review of the effects of eHealth interventions on compliance with immunosuppressant medication in renal transplant recipients
目的 系统评价电子健康干预在肾移植受者免疫抑制剂服药依从性中的应用效果。方法 检索PubMed、Embase、Cochrane Library、CINAHL、Web of Science、知网、万方和维普数据库中关于电子健康干预用于肾移植受者免疫抑制剂服药依从性的随机对照试验。检索时限为建库至2021年12月16日。2名研究者独立检索筛选文献并提取数据。采用Cochrane质量评价手册评估文献质量。使用RevMan 5.3软件进行Meta分析。 结果 共纳入8项研究,涉及791例肾移植受者。与对照组相比,电子健康干预改善了通过电子设备监测的服药依从性[RR=1.46,95%CI（1.11, 1.90）]。但用Basel免疫抑制药物依从性量表评估的服药依从性[RR=1.05,95%CI（0.92,1.20）]、他克莫司血药浓度[SMD=0.16,95%CI（-0.21,0.52）]、他克莫司变异系数[SMD=-0.01,95%CI（-0.05,0.02）]方面,差异无统计学意义（P>0.05）。结论 电子健康干预是否能改善肾移植受者免疫抑制剂服药依从性,在不同评价方式上得出的结论不一致;而且电子健康干预对维持肾移植受者免疫抑制剂血药浓度的效果也有待进一步证实。
刘月 , 沈梅 . 电子健康干预对肾移植受者免疫抑制剂服药依从性影响的系统评价[J]. 中华护理教育, 2022 , 19(9) : 819 -823 . DOI: 10.3761/j.issn.1672-9234.2022.09.010
Objective To investigate the effects of eHealth interventions on improving adherence to immunosup-pressive medications in renal transplant recipients. Methods A systematic search was conducted in PubMed,Embase,Cochrane Library,CINAHL,Web of Science,CNKI,Wanfang,and VIP databases for randomized controlled trials of eHealth interventions on immunosuppressant medication adherence in renal transplant recipients from the establishment of the database to December 16,2021. Two researchers independently searched and screened the articles and extracted data. Study quality was assessed by the Cochrane quality evaluation manual. Meta-analysis was performed by using RevMan5.3 software. Results There were 8 studies involving 791 kidney transplantation recipients. The eHealth interventions improved medication adherence monitored by electronic devices compared to controls[RR=1.46,95%CI（1.11,1.90）]. However,medication adherence as assessed by the Basel Assessment of Adherence to Immunosuppressive Medication Scale [RR=1.05,95%CI（0.92,1.20）],Tacrolimus blood levels [SMD=0.16,95%CI（-0.21,0.52）],Tacrolimus coefficient of variation [SMD=-0.01,95%CI（-0.05,0.02）] was not improved significantly（P>0.05）. Conclusion There are no consistent findings regarding whether eHealth interventions can improve immunosuppressive medication adherence in renal transplant recipients across different studies due to various assessment tools. The effects of eHealth interventions on maintaining immunosuppressive blood levels in renal transplant recipients needs to be further confirmed.
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