一个混合有效性/实施临床试验,对慢性阻塞性肺部疾病的长期氧气治疗的坚持进行临床试验
Valentin Prieto-Centurion1, Kristen E Holm2,3, Richard Casaburi4
1Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep and Allergy.
基于电话的同行指导并没有改善COPD患者的长期氧气治疗 (LTOT) 坚持. 然而,主动指导减少了抑郁症状和睡眠障碍,尽管LTOT的坚持性意外地低于反应性指导.
科学领域:
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
- 行为健康 行为健康
背景情况:
- 慢性阻塞性肺病 (COPD) 管理需要进行干预措施,以改善对长期氧气治疗 (LTOT) 的坚持.
- 远程干预的现实有效性,如对LTOT遵守的同行指导,尚未得到充分证实.
研究的目的:
- 评估基于电话的同行辅导对COPD患者LTOT遵守的有效性.
- 评估包括身体,情绪和社会健康在内的二次结果.
- 检查实现领域的覆盖范围,采用和忠诚度.
主要方法:
- 一项实用的混合有效性实施试验随机将444名COPD患者分配给常规护理,反应性电话辅导或主动电话辅导.
- 在60天内,LTOT坚持 (主要结果) 被定义为平均使用时间≥17.7小时/天.
- 二次结果包括患者报告结果管理信息系统 (PROMIS) 措施;通过电话收集的数据在30,60和90天.
主要成果:
- 60天后LTOT的坚持率为74% (常规护理),84% (反应式指导) 和70% (主动式指导).
- 与常规护理相比,无论是反应性还是主动性指导都没有显著改善LTOT坚持.
- 积极指导减少了抑郁症状和睡眠障碍,但比反应性指导显示出较低的LTOT坚持.
结论:
- 基于电话的同行指导并没有明确改变COPD患者的LTOT坚持.
- 积极的同行辅导可能对情绪和睡眠有好处,但需要进一步的研究.
- 需要进行额外的研究来澄清主动和反应式辅导策略之间的LTOT遵守的差异.
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