rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2021-65-6-549-556rfhealth-639Research ArticleПРОФИЛАКТИКА НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙPREVENTION OF NONINFECTIOUS DISEASESВозможности телемедицинского мониторинга факторов риска у пациентов с кардиоваскулярными заболеваниями: опыт использования пациент-ориентированной модели дистанционной реабилитационной помощиPossibilities of telemedical monitoring risk factors in patients with cardiovascular diseases: experience of using a patient-oriented model of remote rehabilitation carehttps://orcid.org/0000-0002-5263-5409КотельниковаЕлена ВладимировнаKotelnikovaElena V.

Канд. мед. наук, ст. науч. сотр. НИИ кардиологии ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России, 410012, Саратов.

e-mail: kotel_elena@mail.ru

MD, PhD, senior researcher of the Research Institute of Cardiology of the Saratov State Medical University, Saratov, 410012, Russian Federation.

e-mail: kotel_elena@mail.ru

kotel_elena@mail.ruhttps://orcid.org/0000-0003-0496-4504СенчихинВ. Н.SenchikhinValery N.noemail@neicon.ruhttps://orcid.org/0000-0002-7755-1834ЛипчанскаяТ. П.LipchanskayaTatyana P.noemail@neicon.ruНаучно-исследовательский институт кардиологии ФГБОУ ВО «Саратовский государственный медицинский университет имени В.И. Разумовского» Минздрава РоссииV.I. Razumovsky Saratov State Medical University, Research Institute of Cardiology202124122021656549556Copyright © Котельникова Е.В., Сенчихин В.Н., Липчанская Т.П., 20212021Котельникова Е.В., Сенчихин В.Н., Липчанская Т.П.Kotelnikova E.V., Senchikhin V.N., Lipchanskaya T.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/639Введение

Введение. Современная система профилактики кардиоваскулярных заболеваний, наряду с созданием условий для формирования и поддержания здорового образа жизни, предусматривает деятельность в области разработки систем мониторинга информации о факторах риска (ФР).

Цель

Цель: оценить возможности телемедицинского мониторинга кардиоваскулярных ФР в структуре пациент-ориентированной модели дистанционной кардиологической реабилитационной помощи (ДКР). 

Материал и методы

Материал и методы. В исследование включались пациенты с ишемической болезнью сердца или/и артериальной гипертензией I–III степени без когнитивной дисфункции и противопоказаний к физической реабилитации, имеющие мобильное устройство с выходом в интернет. Выделены группы: ДКР, с участием пациентов в 12-месячной программе (28 пациентов, 86% мужчин, средний возраст 55,2 ± 10,7 года), и традиционного наблюдения (30 пациентов, 80% мужчин, средний возраст 64,7 ± 6,9 года). Модель ДКР предусматривала офисное консультирование с применением системы поддержки принятия решений, мониторинг показателей на основе приборов цифровой регистрации, мобильных приложений и электронного «Дневника пациента», отложенное телемедицинское консультирование. Эффективность наблюдения оценивалась по динамике модифицируемых ФР; удовлетворённость пациентов ДКР — по опроснику «Шкала удовлетворённости пациента». 

Результаты

Результаты. После ДКР наблюдалось достоверное снижение систолического и диастолического артериального давления, общего холестерина, холестерина липопротеидов низкой плотности и триглицеридов; а также тенденция к повышению физической активности. По завершении программы отмечен высокий уровень удовлетворённости телемедицинской помощью. 

Заключение

Заключение. Результаты пилотного этапа исследования, посвящённого изучению возможностей ДКР в контексте получения максимальной пользы для кардиоваскулярной профилактики, свидетельствуют о возможности применения пациент-ориентированной модели ДКР с целью мониторинга и модификации ФР у пациентов с кардиоваскулярными заболеваниями.

Introduction

Introduction. The modern system for the prevention of cardiovascular diseases and the creation of conditions for the formation and maintenance of a healthy lifestyle (coolant) includes activities in the development of monitoring systems for information on risk factors. 

Purpose

Purpose: to assess the capabilities of telemedicine monitoring of cardiovascular risk factors in the structure of a patient-oriented model of distance rehabilitation care. 

Material and methods

Material and methods. The study included patients with coronary heart disease and/or arterial hypertension of the I–III degree, without cognitive dysfunction and contraindications to physical rehabilitation, with a mobile device with Internet access. The following groups were distinguished: remote cardiac rehabilitation, with the participation of patients in a 12-month program (28 patients, 86% of men, average age 55.2 ± 10.7 years), and traditional follow-up (30 patients, 80% of men, average age 64.7 ± 6.9 years). Remote cardiac rehabilitation model provided for office consulting using a decision support system, monitoring indicators based on digital recording devices, mobile applications and the electronic «Patient Diary» deferred telemedicine counselling. The effectiveness of the observation was evaluated by the trend of the modified risk factors; patient satisfaction with remote assistance — according to the «Client Satisfaction Questionnaire — CSQ-8» questionnaire. 

Results

Results. After completion of the remote cardiac rehabilitation (RCR) program, a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and triglycerides were observed, and a tendency to increase physical activity. Upon completion of the RCR-program, a high level of satisfaction with telemedicine assistance was noted. 

Conclusion

Conclusion. The results of the pilot phase of the study, dedicated to the study of the possibilities of remote rehabilitation in the context of maximizing the benefits for cardiovascular prophylaxis, indicate the possibility of using a patient-oriented model of remote cardiac rehabilitation to monitor and modify risk factors in patients with cardiovascular diseases.

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The authors declare that there are no conflicts of interest present.