Longitudinal Evaluation of an Integrated Post-COVID-19/Long COVID Management Program Consisting of Digital Interventions and Personal Support: Randomized Controlled Trial

Journal of Medical Internet Research(2023)

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摘要
Background: The postacute COVID-19 syndrome (PACS) can be addressed with multidisciplinary approaches, including professional support and digital interventions. Objective: This research aimed to test whether patients who received a health care facilitation program including medical internet support from human personal pilots and digital interventions (intervention group [IG] and active control group [ACG]) would experience fewer symptoms and have higher work ability and social participation than an untreated comparison group (CompG). The second objective was to compare the impact of a diagnostic assessment and digital interventions tailored to patients' personal capacity (IG) with that of only personal support and digital interventions targeting the main symptoms (ACG). Methods: In total, 1020 patients with PACS were recruited. Using a randomized controlled trial design between the IG and the ACG, as well as propensity score matching to include the CompG, analyses were run with logistic regression and hierarchical-linear models. Results: Symptoms decreased significantly in all groups over time (beta T1-T2=0.13, t(549)=5.67, P<.001; beta T2-T4=0.06, t(549)=2.83, P=.01), with a main effect of the group (beta=-.15, t(549)=-2.65, P=.01) and a more pronounced effect in the IG and ACG compared to the CompG (between groups: beta T1-T2=0.14, t(549)=4.31, P<.001; beta T2-T4=0.14, t(549)=4.57, P<.001). Work ability and social participation were lower in the CompG, but there was no significant interaction effect. There were no group differences between the IG and the ACG. Conclusions: Empowerment through personal pilots and digital interventions reduces symptoms but does not increase work ability and social participation. More longitudinal research is needed to evaluate the effects of a diagnostic assessment. Social support and digital interventions should be incorporated to facilitate health care interventions for PACS.
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关键词
postacute COVID-19 syndrome,PACS,symptom reduction,work ability,social participation,personal pilots,digital interventions,empowerment,randomized controlled trial,propensity score matching,COVID-19
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