早期诊断和治疗COPD和喘 - 一个随机对照试验
Shawn D Aaron1, Katherine L Vandemheen1, G Alex Whitmore1
1From the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (S.D.A., K.L.V., G.G.A., S.M.), the Desautels Faculty of Management (G.A.W.) and the Department of Medicine (N.E.), McGill University, and the Department of Medicine, Université de Montreal (C.L.), Montreal, the Department of Medicine, University of British Columbia, Vancouver (C.B.), Centre de Recherche, Hôpital Laval, Université Laval, Quebec, QC (L.-P.B., A.C.), Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON (R.A.M.), the Department of Medicine, University of Saskatchewan, Saskatoon (E.P.), Cumming School of Medicine, University of Calgary, Calgary, AB (S.K.F.), the Department of Medicine, University of Alberta, Edmonton (I.M., M.B.), the Department of Medicine, Memorial University, St. John's, NL (T.A.), the Department of Medicine, Queen's University, Kingston, ON (M.D.L.), the Department of Medicine and the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto (S.G.), the Department of Medicine, University of Western Ontario, London (C.J.L.), the Department of Medicine, Dalhousie University, Halifax, NS (P.H.), and the Department of Medicine, University of Manitoba, Winnipeg (M.A.) - all in Canada.
早期诊断和肺科医生主导的治疗未被诊断的慢性阻塞性肺病 (COPD) 和喘显著减少了呼吸系统医疗保健的利用率. 这种方法改善了患者的治疗结果和生活质量.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 临床试验研究 临床试验研究
背景情况:
- 许多患有慢性阻塞性肺病 (COPD) 或喘的人仍然未被诊断,导致未经治疗的呼吸道症状.
- 未被诊断的呼吸道疾病有助于增加医疗保健利用率和更差的健康结果.
研究的目的:
- 为了确定早期诊断和专家领导的治疗是否会减少未被诊断的COPD或喘的成年人的医疗保健利用.
- 评估早期干预对呼吸系统健康结果,生活质量和症状负担的影响.
主要方法:
- 一个寻找病例的策略确定了患有呼吸道症状和未诊断的肺部疾病的成年人.
- 患有未诊断的COPD或喘的参与者接受了螺旋测量,并随机分配到干预组 (肺科医生评估和基于指南的护理) 或通常护理组.
- 主要结局:参与者发起的呼吸系统卫生保健利用率. 二次结果:圣乔治呼吸问卷 (SGRQ),COPD评估测试 (CAT) 成绩,以及1秒内强制呼吸量 (FEV1).
主要成果:
- 干预组的呼吸系统卫生保健利用率年化显著较低 (0.53对1.12事件/人/年).
- 与常规护理相比,干预组在生活质量 (SGRQ: -10.2分) 和症状负担 (CAT: -3.8分) 上有显著改善.
- 干预组 (119毫升) 的1秒内强制呼气量 (FEV1) 比常规护理组 (+22毫升) 的增加更多.
结论:
- 通过肺科医生指导的护理来识别和治疗未被诊断的喘或COPD的策略,显著减少了随后的呼吸系统医疗保健利用率.
- 早期诊断和干预可以改善以前未被诊断的呼吸道疾病患者的生活质量和症状负担.
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