咨询干预措施降低2型糖尿病患者的HbA1c度的有效性:一项建模研究
Mohammed B Sarhan1, Rula Ghandour1, Niveen M E Abu Rmeileh1
1Institute of Community and Public Health, Birzeit University, Birzeit, West Bank, occupied Palestinian territory.
Lancet (London, England)
|March 20, 2018
概括
这项研究发现,基于短信服务 (SMS) 的干预措施在改善2型糖尿病控制方面最有效. 实施这些低成本的初级保健措施可以降低巴勒斯坦的HbA1c水平和糖尿病并发症.
科学领域:
- 公共卫生
- 糖尿病管理
- 医疗服务研究
背景情况:
- 在被占领的巴勒斯坦领土上,2型糖尿病对健康构成越来越大的挑战.
- 有效的血糖控制 (HbA1c) 对于预防糖尿病相关并发症至关重要.
- 全球已探索各种辅导干预措施来管理2型糖尿病.
研究的目的:
- 评估不同初级卫生保健级别咨询干预措施改善2型糖尿病患者血糖控制的有效性.
- 确定巴勒斯坦医疗保健系统的低成本,可行和可接受的干预措施.
主要方法:
- 一项文献审查确定了针对2型糖尿病患者的辅导干预措施.
- 干预措施是根据世卫组织的"最佳购买"标准进行选择的,考虑可行性和可接受性.
- 使用回归分析来估计每个干预措施降低HbA1c度的有效性 (非标准化的β系数).
主要成果:
- 确定了三个有效的咨询干预措施:个人咨询,社区卫生工作者家访和基于短信服务 (SMS) 的咨询.
- 所有干预措施都在降低平均HbA1c度方面表现出有效性.
- 基于短信的干预显示出最高的有效性 (β=0·65),其次是社区卫生工作者干预 (β=0·27) 和个人咨询 (β=0·14).
结论:
- 实施基于短信咨询等具有成本效益的初级保健干预措施可以显著改善2型糖尿病患者的血糖控制.
- 这些干预措施有可能减少糖尿病并发症的发生率,并减轻巴勒斯坦医疗保健系统的经济负担.
- 这些发现支持将选定的"最佳购买"干预措施纳入巴勒斯坦医疗保健系统,以更好地管理糖尿病.
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