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导向性自我管理和性结肠炎患者指导的随访:一项随机试验
A Robinson1, D G Thompson, D Wilkin
1Section of Gastrointestinal Science, University of Manchester, Clinical Sciences Building, Hope Hospital, M6 8HD, Salford, UK. arobinson@fs1.ho.man.ac.uk
Lancet (London, England)
|October 5, 2001
概括
对性结肠炎 (UC) 患者的以患者为中心的自我管理培训加速了复发治疗,并减少了医生访问. 这种方法可以提高医疗保健的效率,而不会增加病率,为传统的门诊护理提供了可行的替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
背景情况:
- 性结肠炎 (UC) 管理依赖于专家门诊审查.
- 目前的模型并没有提高患者参与度,也没有减少医生依赖.
- 需要替代护理模型来优化UC管理.
研究的目的:
- 评估以患者为中心的自我管理培训,作为性结肠炎传统门诊护理的替代方案.
- 评估自我管理对治疗及时性和医疗保健利用的影响.
- 确定对患者生活质量和发病率的影响.
主要方法:
- 一项随机对照试验,涉及203名接受医院随访的UC患者.
- 干预组接受了自我管理培训和按需的后续照顾.
- 对照组接受标准治疗和随访;进行治疗意向分析.
主要成果:
- 自主管理的患者经历了更快的复发治疗 (14.8小时 vs 49.6小时).
- 在干预组中,医院 (0.9 vs 2.9) 和初级保健访问 (0.3 vs 0.9) 显著减少.
- 与健康有关的生活质量在不同组之间保持不变.
结论:
- 以患者为中心的自我管理加速了性结肠炎的治疗,减少了医疗保健咨询.
- 这种方法是安全的,不会增加发病率,并提高了医疗服务的提供.
- 自治策略显示出管理其他慢性疾病的潜力,提高效率和降低成本.
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