使用以患者为中心的护理模式管理多病症:3D方法的实用集群随机试验
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
概括
患者为中心的3D方法并没有改善多种慢性疾病患者的生活质量. 这项大型试验与多种疾病管理的通常治疗相比没有显著差异.
科学领域:
- 老年学
- 公共卫生
- 医疗服务研究
背景情况:
- 管理多种慢性疾病 (多种疾病) 是医疗保健系统面临的挑战.
- 国际共识主张以患者为中心的护理,专注于生活质量和自我管理.
- 在多种疾病中以患者为中心的方法的有效性是有限的.
研究的目的:
- 测试以患者为中心的3D方法改善多病症患者的健康相关生活质量.
- 这种三维方法考虑了健康,抑郁和毒品等方面.
主要方法:
- 在英语和苏格兰的一般实践中实用集群随机试验.
- 随机分配到通常的护理或每6个月一次的3D审查.
- 招募了1546名患有多种疾病的成年人;主要结果是15个月后的生活质量 (EQ- 5D- 5L).
主要成果:
- 3D干预组与常规治疗组之间没有显著的生活质量差异 (调整后的差异为0. 00,95% CI- 0. 02至0. 02;p=0. 93).
- 这项试验包括33个全科医院的1546名患者.
- 患者的死亡与干预无关.
结论:
- 基于多种疾病管理的国际共识的3D干预措施没有改善患者的生活质量.
- 这项研究代表了对多病症的最佳管理的广泛调查.
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