在初级保健中使用保守干预措施治疗男性下泌尿道症状:集群随机对照试验
Marcus J Drake1, Jo Worthington2, Jessica Frost2
1Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Hammersmith Hospital, London, UK mjdrake@imperial.ac.uk.
BMJ (Clinical research ed.)
|November 15, 2023
概括
一项新的初级保健干预措施在12个月内显著减少了男性下泌尿道症状 (LUTS). 与常规护理相比,这种标准化护理方法改善了症状得分和生活质量.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 下尿道症状 (LUTS) 显著影响男性的生活质量.
- 目前的初级保健管理往往缺乏标准化,手工化的方法.
- 需要证据来评估在初级保健机构中针对LUTS的结构化干预措施.
研究的目的:
- 评估标准化,手动化的护理干预措施是否能改善初级护理中的男性的LUTS,而不是通常的护理.
- 评估对症状严重程度,生活质量和医疗保健利用率的影响.
主要方法:
- 一个集群随机对照试验,涉及1077名在英国30家全科医院有烦人的LUTS的男性.
- 干预组在12周内收到了标准化的信息小册子和指导支持.
- 主要结局:12个月的国际前列腺症状评分 (IPSS),使用混合效应多层回归分析.
主要成果:
- 干预组在12个月后显示出平均IPSS的统计学显著下降 (调整后平均差异-1.81分).
- 还观察到LUTS特异性生活质量,失禁和症状感知方面的改善.
- 干预和常规护理组之间的泌尿器科转诊率和不良事件率相似.
结论:
- 一个标准化和手动化的干预措施有效地减少了12个月的初级保健男性的LUTS.
- 虽然减少达到统计学意义,但略低于预定义的最低临床重要差异目标.
- 这种结构化的方法提供了一种可行的策略,用于在初级保健中管理LUTS,改善患者的治疗结果.
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