对于提供者来说,未来的多模式教育干预措施不会增加肝脏脑病治疗率
Patrick A Twohig1, Thoetchai Bee Peeraphatdit2, Kaeli Samson3
1Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, 982000 Medical Center Drive, Omaha, NE, 68198-2000, USA. patwohig@gmail.com.
Digestive diseases and sciences
|April 23, 2024
概括
多模式教育干预措施并没有改善肝脑病变 (HE) 的治疗率. 需要采取替代策略来解决障碍,并增加HE患者的医疗治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 医学教育 医学教育
背景情况:
- 肝脑病 (HE) 住院治疗往往是可以预防的,但许多患者没有得到及时的医疗治疗.
- 识别和克服HE治疗的障碍对于改善患者的治疗结果至关重要.
研究的目的:
- 实施和评估一项多式模式教育干预 (MMEI),旨在提高肝脑病变 (HE) 的治疗率.
- 分析HE治疗的趋势,确定接受治疗的预测因素,并评估治疗对住院结果的影响.
主要方法:
- 一个前性,单中心的队列研究进行了30个月,比较15个月的控制期 (MMEI前) 与15个月的干预期 (MMEI).
- 该MMEI包含了事先授权资源,电子订单集和面对面的提供者教育.
- 治疗被定义为接受乳糖,利法西明或组合疗法;使用后勤回归比较率.
主要成果:
- MMEI并没有显著增加接受HE任何药物治疗的总体几率 (p=0.03).
- 在MMEI后,组合治疗率保持不变 (p=0.32).
- 接受治疗的预测因素包括与酒精有关的/密码性肝硬化,,门高血压;自身免疫性肝硬化是接受*不*治疗的预测因素. 被内科医生看的患者或中毒的患者不太可能接受rifaximin. 任何治疗都与30天的肝病再入院率较高有关 (p<0.001).
结论:
- 实施的多式联通教育干预措施未能提高高等教育治疗率.
- 对替代策略的进一步研究是必要的,以有效地解决障碍,并加强肝脏脑病患者的医疗治疗.
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