在患有系统性红斑狼的患者中实施临床医生主导的药物坚持干预
Kai Sun1, Nneka J Molokwu2, Emily Hanlen-Rosado2
1K. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine; kai.sun@duke.edu.
The Journal of rheumatology
|June 2, 2024
概括
这项研究评估了一项临床医生主导的干预措施,以改善系统性红斑狼 (SLE) 的药物坚持. 该干预表明可行性和可接受性,一些患者改善了坚持,突出了进一步优化需求.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在全身性红斑狼 (SLE) 中,药物不服药显著恶化了患者的结果.
- 使用实时补充数据和通信的临床医生主导的干预措施被开发出来,以解决不坚持.
- 之前的试点测试表明,对药物坚持有积极影响.
研究的目的:
- 评估SLE患者临床医生主导的坚持干预措施的实施情况.
- 确定改善干预交付和患者体验的领域.
主要方法:
- 编码了25次患者与临床医生接触的音频录音,这些录音是针对非坚持性SLE患者的 (覆盖日数比例[PDC]<80%).
- 分析了干预组件,沟通质量和对遵守的时间.
- 与患者和临床医生进行半结构面试,探索经验和建议,并进行干预后的PDC评估.
主要成果:
- 临床医生在干预组件和优秀的沟通方面表现出了高保真度.
- 坚持讨论的平均时间为3.8分钟;44%的患者显示PDC增加≥20%.
- 患者报告说,他们感觉得到倾听,对不遵守更诚实,有动力,强调沟通和支持.
结论:
- 坚持干预是可行的,可以接受的,并忠实地实施.
- 患者报告的结果表明对诚实和动机有积极的影响.
- 未来的研究将专注于优化临床医师培训和进行大型随机试验.
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