Dataset Information

Self-management of peripherally inserted central catheters after patient discharge via the WeChat smartphone application: A systematic review and meta-analysis.

ABSTRACT: WeChat is a smartphone application that may help patients self-manage peripherally inserted central catheters (PICC), although additional data are needed regarding this topic. This systematic review and meta-analysis aimed to determine whether WeChat helped improve PICC-related complications, self-care ability, PICC maintenance dependency in that the behavior of a patient is in compliance with a doctor's order or a will, knowledge mastery, and satisfaction among patients with a PICC. The PubMed, Embase, Cochrane Library, China Biology Medicine, China national Knowledge Infrastructure, Wanfang, Wiper, and Baidu Scholar databases were searched to identify related reports that were published up to April 2018. This search revealed 36 reports that were published during 2014-2018, including 2,623 controls and 2,662 patients who used the WeChat application. Relative to the traditional follow-up group, the group that received WeChat follow-up had a lower risk of PICC-related complications (odds ratio [OR]: 0.23, 95% confidence interval [CI]: 0.19-0.27, P < 0.00001), better self-care ability (mean difference: 36.41, 95% CI: 34.68-38.14, P < 0.00001), higher PICC maintenance dependency (OR: 4.27, 95% CI: 3.35-5.44, P < 0.00001), and higher patient satisfaction (OR: 6.20, 95% CI: 4.32-8.90, P < 0.00001). Eight studies reported knowledge mastery, although the different evaluation tools precluded a meta-analysis. Nevertheless, those eight studies revealed that knowledge mastery was significantly higher in the WeChat group than in the traditional follow-up group (P < 0.05). To the best of our knowledge, this is the first meta-analysis to evaluate the effects of WeChat follow-up on self-management among patients who are discharged with a PICC. It appears that WeChat follow-up can help improve the incidence of complications, self-care ability, PICC maintenance dependence, and patient satisfaction. However, the WeChat application itself cannot improve patients' self-management ability. Further studies are needed to produce high-quality evidence to determine whether WeChat is an effective follow-up tool.

SUBMITTER: Ma D

PROVIDER: S-EPMC6112638 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Self-management of peripherally inserted central catheters after patient discharge via the WeChat smartphone application: A systematic review and meta-analysis.

Ma Donghua D Cheng Kangwen K Ding Ping P Li Hongyan H Wang Ping P

PloS one 20180828 8

WeChat is a smartphone application that may help patients self-manage peripherally inserted central catheters (PICC), although additional data are needed regarding this topic. This systematic review and meta-analysis aimed to determine whether WeChat helped improve PICC-related complications, self-care ability, PICC maintenance dependency in that the behavior of a patient is in compliance with a doctor's order or a will, knowledge mastery, and satisfaction among patients with a PICC. The PubMed, ...[more]

PMID: 30153253

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Project description:Use of peripherally inserted central catheters has expanded rapidly, but the consequences for patients who eventually require hemodialysis are undefined.Our national, population-based analysis included 33,918 adult Medicare beneficiaries from the US Renal Data System who initiated hemodialysis with central venous catheters as their sole vascular access in 2010 and 2011. We used linked Medicare claims to identify peripherally inserted central catheter exposures and evaluate the associations of peripherally inserted central catheter placement with transition to working arteriovenous fistulas or grafts and patient survival using a Cox model with time-dependent variables.Among 33,918 individuals initiating hemodialysis with a catheter as sole access, 12.6% had received at least one peripherally inserted central catheter. Median follow-up was 404 days (interquartile range, 103-680 days). Among 6487 peripherally inserted central catheters placed, 3435 (53%) were placed within the 2 years before hemodialysis initiation, and 3052 (47%) were placed afterward. Multiple peripherally inserted central catheters were placed in 30% of patients exposed to peripherally inserted central catheters. Recipients of peripherally inserted central catheters were more likely to be women and have comorbid diagnoses and less likely to have received predialysis nephrology care. After adjustment for clinical and demographic factors, peripherally inserted central catheters placed before or after hemodialysis initiation were independently associated with lower likelihoods of transition to any working fistula or graft (hazard ratio for prehemodialysis peripherally inserted central catheter, 0.85; 95% confidence interval, 0.79 to 0.91; hazard ratio for posthemodialysis peripherally inserted central catheter, 0.81; 95% confidence interval, 0.73 to 0.89).Peripherally inserted central catheter placement was common and associated with adverse vascular access outcomes. Recognition of potential long-term adverse consequences of peripherally inserted central catheters is essential for clinicians caring for patients with CKD.

Project description:BackgroundPeripherally inserted central catheters (PICCs) are used commonly to administer antibiotics to people with cystic fibrosis (CF), but their use can be complicated by venous thrombosis and catheter occlusion.Research questionWhich participant-, catheter-, and catheter management-level attributes are associated with increased risk of complications of PICCs among people with CF?Study design and methodsThis was a prospective observational study of adults and children with CF who received PICCs at 10 CF care centers in the United States. The primary end point was defined as occlusion of the catheter resulting in unplanned removal, symptomatic venous thrombosis in the extremity containing the catheter, or both. Three categories of composite secondary outcomes were identified: difficult line placement, local soft tissue or skin reactions, and catheter malfunction. Data specific to the participant, catheter placement, and catheter management were collected in a centralized database. Risk factors for primary and secondary outcomes were analyzed by multivariate logistic regression.ResultsBetween June 2018 and July 2021, 157 adults and 103 children older than 6 years with CF had 375 PICCs placed. Patients underwent 4,828 catheter-days of observation. Of the 375 PICCs, 334 (89%) were ≤ 4.5 F, 342 (91%) were single lumen, and 366 (98%) were placed using ultrasound guidance. The primary outcome occurred in 15 PICCs for an event rate of 3.11 per 1,000 catheter-days. No cases of catheter-related bloodstream infection occurred. Other secondary outcomes developed in 147 of 375 catheters (39%). Despite evidence of practice variation, no risk factors for the primary outcome and few risk factors for secondary outcomes were identified.InterpretationThis study affirmed the safety of contemporary approaches to inserting and using PICCs in people with CF. Given the low rate of complications in this study, observations may reflect a widespread shift to selecting smaller-diameter PICCs and using ultrasound to guide their placement.

Project description:OBJECTIVES:To assess the effect on needed nursing time for dressing change. DESIGN, SETTING, PARTICIPANTS:A parallel-group, open-label, randomised controlled trial in patients who are in need for a peripherally inserted central catheter insertion in one teaching hospital in Belgium. The follow-up lasted 180 days or until catheter removal, whatever came first. A computer generated table was used to allocate devices. Randomised patients were 105 adults (StatLock, n=53; SecurAcath, n=52) and primary analysis was based on all patients (n=92) with time measurements (StatLock, n=43; SecurAcath, n=49). INTERVENTIONS:StatLock which has to be changed weekly versus SecurAcath which could remain in place for the complete catheter dwell time. MAIN OUTCOME MEASURE:Needed time for the dressing change at each dressing change (SecurAcath) or at each dressing change combined with the change of the securement device (StatLock). RESULTS:Median time needed for dressing change was 7.3?min (95%?CI 6.4?min to 8.3?min) in the StatLock group and in the SecurAcath group 4.3?min (95%?CI 3.8 min to 4.9?min) (P<0.0001). The time in the SecurAcath group was reduced with 41% (95% CI 29% to 51%). Incidence rates of migration, dislodgement and catheter-related bloodstream infection were comparable across groups. Pain scores were higher with SecurAcath than with StatLock at insertion (P=0.02) and at removal (P<0.001) and comparable during dressing change (P=0.38) and during dwell time (P=0.995). User-friendliness was scored at insertion and removal. All statements regarding the user-friendliness were scored significantly higher for StatLock than for SecurAcath (P<0.05). Only for the statement regarding the recommending routine use of the device, which was asked at removal, no difference was found between the two devices (P=0.32). CONCLUSION:Use of SecurAcath saves time during dressing change compared with StatLock. Training on correct placement and removal of SecurAcath is critical to minimise pain. TRIAL REGISTRATION NUMBER:NCT02311127; Pre-results.

Dataset Information

Self-management of peripherally inserted central catheters after patient discharge via the WeChat smartphone application: A systematic review and meta-analysis.

Publications

Self-management of peripherally inserted central catheters after patient discharge via the WeChat smartphone application: A systematic review and meta-analysis.

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