3Dアプローチのプラグマティックなクラスターランダム化試験
Chris Salisbury1, Mei-See Man1, Peter Bower2
1Centre for Academic Primary Care, NIHR School for Primary Care Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Lancet (London, England)
|July 3, 2018
まとめ
患者中心の3Dアプローチは 複数の慢性疾患の患者の生活の質を 改善しませんでした この大規模な試験では,多発性疾患の管理における通常の治療と比較して,有意な差異は認められなかった.
科学分野:
- ゲロントロジー
- 公衆衛生
- 医療サービス研究
背景:
- 複数の慢性疾患 (多発性) を管理することは,医療システムにとって課題です.
- 国際的なコンセンサスでは 患者のケアを中心に 生活の質と自己管理に焦点を当てています
- 患者中心のアプローチの有効性に関する証拠は限られている.
研究 の 目的:
- 患者中心の3Dアプローチが多発性患者の健康関連の生活の質を向上させるという仮説を検証する.
- 3Dアプローチは健康,鬱,薬物といった側面を考慮します
主な方法:
- 英語とスコットランドの一般診療におけるプラグマティック・クラスター・ランダム化試験
- 通常のケアまたは6ヶ月の3Dレビューにランダムに割り当てられました.
- 患者数は1546人,主なアウトカムは15ヶ月の生活の質 (EQ-5D-5L) でした.
主要な成果:
- 3D介入群と通常の治療群の生活の質の有意な差はありません (調整された差は0. 00,95%CI- 0. 02から0. 02;p=0. 93).
- 臨床試験には33の総合診療所の患者1546人が参加しました.
- 患者の死亡は介入と関連していない.
結論:
- 3D介入は,多発性疾患の管理に関する国際的コンセンサスに基づいていますが,患者の生活の質を向上させませんでした.
- この研究は,多発性疾患の最適な管理に関する大規模な調査です.
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