Eficácia dos sistemas de registo eletrónico para melhorar o cumprimento do tratamento e as tarefas de finalização em doentes com tuberculose: uma metaanálisis
DOI:
https://doi.org/10.47197/retos.v74.117393Palavras-chave:
Tuberculose, lembretes eletrónicos, adesão, conclusãoResumo
Introdução: Numerosos estudos avaliaram os sistemas de registos eletrónicos (ERS) para melhorar os resultados do tratamento da tuberculose (TB), mas os hallazgos recentes são inconsistentes.
Objectivo: O objectivo deste estudo foi avaliar a eficácia do ERS para melhorar o cumprimento e a finalização do tratamento entre os doentes com TB.
Metodologia: Análise de sistemática e meta-análise. Os estudos incluíram a obtenção de seis bases de dados (PubMed, MedLine Ultimate, WOS, ASC, CINAHL e Garuda) até 26 de maio de 2025. Foi utilizada a ferramenta Risk of Bias para avaliar a qualidade dos artigos. Cálculo e análise da odds ratio (OR) utilizando o efeito aleatório e o intervalo de confiança (IC) a 95%.
Resultados: Uma vez que os estudos cumprem os critérios de elegibilidade para esta revisão.
O ERS melhorou significativamente a adesão ao tratamento (OR = 1,97, IC a 95% [1,05, 3,69], p = 0,04; I² = 85%) e a finalização do tratamento (OR = 1,57, IC a 95% [1,08, 2,27], p = 0,02; I² = 75%). A análise de subgrupos mostrou um efeito significativo na adesão nos países de baixa e média entrada (PIBM) (OR = 1,97, IC a 95% [1,16, 3,35], p = 0,01; I² = 0 %), mas não nos países de média-alta entrada (PIMA) (OR = 1,87, p = 0,14; I² = 91%). Nenhum subgrupo alcançou significado estatístico no que diz respeito à finalização, embora o efeito global continuasse a ser sólido. O teste de diferenças entre subgrupos não foi significativo para nenhum dos resultados (p = 0,92 para a adesão; p = 0,11 para a finalização).
Conclusões: Os ERS são eficazes para melhorar o cumprimento e a finalização do tratamento da tuberculose, com evidência mais sólida e consistente nos países de baixo e médio ingresso. Estes hallazgos apoiam a sua integração nos programas nacionais contra a tuberculose em ambientes com recursos limitados como um complemento de baixo custo e escalável de acordo com a atenção padrão. Estes hallazgos refuerzan a ideia de que as ferramentas digitais sencillas podem marcar uma diferença significativa, especialmente quando se implementa cuidados de forma nos ambientes adequados.
Registo: CRD420251072331 registado em PROSPERO..
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