聚焦改善患者依从性和临床结局的数字免疫治疗管理系统在屋尘螨集群皮下免疫治疗中的贡献：基于前后对照设计评估
Contribution of a Digital Immunotherapy Management System Focusing on Improved Patient Adherence and Clinical Outcomes in House Dust Mite Rush Subcutaneous Immunotherapy Evaluated with a Before-After Design.
文献信息
| PMID | 42936780 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yanni Xu |
| 作者单位 | Institute of Respiratory Diseases National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China. |
| 期刊 | Patient preference and adherence |
| SCI 分区 | Q2 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 集群皮下免疫治疗（RIT）需要频繁注射、严格的治疗间隔和长期随访。数字化管理整合了注射排程、提醒、治疗记录和患者报告的随访。
目的： 本研究旨在评估数字免疫治疗管理系统与接受RIT患者的依从性和临床结局之间的关联。
方法： 本研究采用单中心回顾性常规治疗（前）后接数字化治疗（后）的前后对照研究设计，评估2022年1月至2025年5月在中国一家三级医院接受屋尘螨（HDM）RIT的患者。在数字免疫治疗管理系统实施前接受治疗的患者被分配至常规管理组（CMG），而实施后接受治疗的患者被分配至数字管理组（DMG）。比较了两组的依从性、维持治疗完成情况、肺功能、炎症和免疫学指标、鼻结膜炎生活质量问卷（RQLQ）以及症状与用药综合评分（CSMS）。
结果： 共纳入129例患者，CMG组58例，DMG组71例，两组基线特征无显著差异（均P > 0.05）。1年时，CMG组有49例患者、DMG组有66例患者接受了评估。DMG组良好的按时注射依从性（72.7% vs 46.9%，P=0.005）和维持治疗完成率（81.8% vs 61.2%，P=0.014）更高。DMG组第1秒用力呼气容积（FEV1；P=0.037）和用力肺活量（FVC；P=0.035）更高，RQLQ（P<0.001）和CSMS（P=0.013）评分更低。数字化管理与维持治疗完成相关（校正OR=4.628，95% CI 1.099-19.486；P=0.037）。
结论： 数字化管理与更好的注射依从性、维持治疗完成率及部分临床结局相关，而炎症和免疫学发现需谨慎解读。数字化管理可能有助于患者在长期RIT期间维持规律注射并完成维持治疗。时间性混杂限制了因果推断；需要前瞻性多中心研究。
英文摘要
BACKGROUND: Rush subcutaneous immunotherapy (RIT) requires frequent injections, strict treatment intervals, and long-term follow-up. Digital management integrates injection scheduling, reminders, treatment records, and patient-reported follow-up.
OBJECTIVE: This study aimed to evaluate the association of a digital immunotherapy management system with adherence and clinical outcomes in patients undergoing RIT.
METHODS: This single-center retrospective conventional treatment (Before) followed by digital treatment (After) study design was used to evaluate patients who underwent house dust mite (HDM) RIT at a tertiary hospital in China between January 2022 and May 2025. Patients treated before implementation of the digital immunotherapy management system were assigned to the conventional management group (CMG), whereas those treated after implementation were assigned to the digital management group (DMG). Adherence, maintenance therapy completion, pulmonary function, inflammatory and immunological indicators, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and the Combined Symptom and Medication Score (CSMS) were compared.
RESULTS: A total of 129 patients were included, 58 in the CMG and 71 in the DMG, with no significant differences in baseline characteristics between the two groups (all P > 0.05). At 1 year, 49 patients in the CMG and 66 patients in the DMG were evaluated. Good on-time injection adherence (72.7% vs 46.9%, P=0.005) and maintenance completion (81.8% vs 61.2%, P=0.014) were higher in the DMG. The DMG had higher forced expiratory volume in 1 second (FEV1; P=0.037) and forced vital capacity (FVC; P=0.035), and lower RQLQ (P<0.001) and CSMS (P=0.013) scores. Digital management was associated with maintenance completion (adjusted OR=4.628, 95% CI 1.099-19.486; P=0.037).
CONCLUSION: Digital management was associated with better injection adherence, maintenance completion, and selected clinical outcomes, while inflammatory and immunological findings require cautious interpretation. Digital management may help patients maintain regular injections and complete maintenance therapy during long-term RIT. Temporal confounding limits causal inference; prospective multicenter studies are needed.