Zhongguo quanke yixue (Nov 2023)
Application of Mobile Smart Healthcare in the Prevention and Control of Cardiovascular Diseases in Elderly Patients with Chronic Diseases in Primary Care
Abstract
Background The advantages of mobile smart healthcare in screening, intervention, treatment, and management of cardiovascular diseases have become increasingly prominent in recent years. The application value of wearable single lead electrocardiogram equipment in the early screening and diagnosis of arrhythmia patients out of the hospital has been recognized by scholars and clinical workers. However, its application in risk screening and long-term follow-up management of chronic disease patients in primary care is limited by the single function of the cloud platform led and matched by it. Objective To explore the application value of mobile smart healthcare in the prevention and control of cardiovascular disease risk in elderly patients with chronic disease in primary care from the perspective of chronic disease prevention and control and using wearable single lead electrocardiogram equipment as carriers, based on hierarchical medical system. Methods A total of 3 000 patients with chronic disease aged above 65 years admitted to primary care institutions in Ningxia from January 2022 to August 2022 were selected as research subjects, including 1 202 males and 1 798 females with an average age of (71.3±5.0) years. The baseline data were recorded by primary care physicians through mobile phone APP and cloud platform of patient management, 72-hour ECG data collected by wearable single lead electrocardiogram equipment were also uploaded to cloud platform of patient management. Analysis of data and risk stratification for arrhythmia, heart rate variability (HRV) and obstructive sleep apnea hypopnea syndrome (OSAHS) were performed by professional electrocardiographers, and the corresponding marks on the cloud platform for the data with low, medium and high risk of cardiovascular disease were ticked according to the stratification results of the three analysis methods. The cloud platform notifies primary care physicians of high and medium risk data in the form of SMS for the management of different processes of patients. The number of detected cases with different risk stratification, the number of detected cases and rates of management according to the process among patients with low, medium and high risk of cardiovascular disease were counted. Results Arrhythmias were detected in 1 526 (50.87%), 1 349 (44.97%), and 125 (4.17%) cases consistent with negativity, positivity, and significant positivity, respectively; HRV was mildly, moderately, and severely reduced in 2 330 (78.50%), 630 (21.23%), and 8 (0.27%) cases, respectively; OSAHS was consistent with mild, moderate, and severe abnormalities in 1 769 (59.60%), 573 (19.31%), and 626 (21.09%) cases, respectively. The comprehensive risk of cardiovascular disease was low, moderate, and high in 744 (24.80%), 1 640 (54.67%), and 616 (20.53%) patients, respectively. The rates of management according to the process in patients with high, medium and low comprehensive risk of cardiovascular disease were 94.49% (703 cases), 88.10% (1 445 cases) and 100% (616 cases), respectively. Conclusion The elderly patients with chronic disease in primary care with combined application of mobile smart healthcare technology and arrhythmia, HRV, OSAHS analysis methods to the prevention and control of cardiovascular diseases have higher detection rate of cardiovascular disease risk and management rate, which is conducive to the establishment of a cardiovascular disease prevention and control system for them.
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