慢性閉塞性肺疾患の入院患者に対する移行ケアと長期的な自己管理支援を組み合わせたプログラムの効果:ランダム化臨床試験
Hanan Aboumatar1,2,3,4,5, Mohammad Naqibuddin1, Suna Chung1
1Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland.
JAMA
|November 13, 2018
まとめ
新規のCOPD自己管理プログラムにより 患者の入院や緊急診療が大幅に減少しました この介入により 退院後6ヶ月以内に 生活の質も向上しました
科学分野:
- 肺医学
- 医療管理
- 忍耐 し て 自分 を 管理 する
背景:
- COPDの悪化のために入院した患者は,高い再入院率と生活の質の低下に直面します.
- 効果的な介入は 長期的な成果と 患者の福祉を改善するために不可欠です
研究 の 目的:
- COPD患者とその家族の介護者に対する 移行と長期的な自己管理のサポートを組み合わせた 病院主導のプログラムを評価する.
主な方法:
- COPD患者240人を対象とした単一サイトランダム化臨床試験です.
- 参加者は3ヶ月の総合的な自己管理プログラムまたは通常のケアにランダムに割り当てられました.
- 測定されたアウトカムには,COPDに関連する急性ケアイベントと,退院後6ヶ月後の健康関連の生活の質 (セント・ジョージ呼吸器科アンケート) が含まれていた.
主要な成果:
- 介入グループでは,COPDに関連する急性ケアイベントが著しく減少しました (参加者一人当たり0. 72対1. 40).
- 健康に関する生活の質は,通常のケア (平均変化+5.44) と比較して,介入グループで改善しました.
- 介入グループでは入院 (135 vs 202) と死亡 (7 vs 8) が少なかった.
結論:
- 移行と長期的な自己管理のサポートを組み合わせた3ヶ月のプログラムは,COPDに関連する急性ケアイベントを効果的に軽減し,生活の質を向上させました.
- この介入は,入院後のCOPD患者の治療結果を改善する見込みを示しています.
- この介入を様々な状況で評価するためにさらなる研究が推奨されています.
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