在初级保健中早期发现慢性阻塞性肺病:一项随机对照试验
Anthony Chapron1, Emilie Andres2, Laure Fiquet2
1Department of General Practice, University of Rennes, Centre Hospitalier Universitaire (CHU) Rennes, Rennes; UMR_S 1085, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Santé, Environnement et Travail (IRSET), Rennes.
概括
简单的干预措施,如全球慢性阻塞性肺病倡议 (GOLD) 问题和COPD协调,有效地在初级保健中识别新的慢性阻塞性肺病 (COPD) 病例. 慢性慢性病症协调显示,在病例检测方面出现了统计学上显著的改善.
科学领域:
- 肺部病理学 肺部病理学
- 主要护理医学 医疗保健
- 公共卫生 公共卫生
背景情况:
- 慢性阻塞性肺病 (COPD) 在全球范围内被严重诊断不足.
- 早期发现COPD对于及时干预和改善患者结果至关重要.
- 初级保健机构是识别未诊断的COPD病例的关键.
研究的目的:
- 评估全球慢性阻塞性肺病倡议 (GOLD) 问题和COPD协调策略在初级保健中检测新COPD病例的有效性.
- 为了比较这些干预措施的有效性,单独和组合,与标准护理.
主要方法:
- 这是一项多中心,集群随机控制的研究,涉及法国47名全科医生.
- 参与研究的患者年龄在40至80岁之间,以前没有被诊断患有喘或COPD.
- 一般医生被随机分为四组:对照组,GOLD问题,COPD协调或两种干预.
主要成果:
- 在干预组中,仅诊断出24例新COPD病例 (0.8%的受试患者).
- 慢性肺炎协调显著增加了新慢性肺炎病例的检测 (P=0.01).
- 这些干预措施确定了6.8%的经过螺旋计的患者是新的COPD病例.
结论:
- 易于实施的策略,包括GOLD问题和COPD协调,可以在初级保健中成功识别新的COPD病例.
- 需要进一步的研究,以确定不同国家的全科医生最佳的病例发现策略.
- 在初级保健中改善COPD检测可以导致更早的诊断和管理.
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