在分娩后一年内使用远程医疗和接受推服务
Thomas P Kishkovich1,2, Kaitlyn E James1,2, Katie C Orona3
1Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.
Journal of telemedicine and telecare
|December 9, 2024
概括
远程医疗产后护理与较低的巴氏涂抹率和长效可逆避孕药 (LARC) 使用率相比,与面对面的访问有关. 临床医生应该考虑对必要的产后服务进行面对面的访问.
科学领域:
- 产科和妇科 产科和妇科
- 数字健康数字健康
- 公共卫生 公共卫生
背景情况:
- 远程医疗已成为提供产前和产后护理的重要方式.
- 通过远程医疗与面对面访问使用基本产后服务需要进一步调查.
研究的目的:
- 为了比较单独使用远程医疗和接受亲自产后护理的个体之间采用关键产后服务的情况.
- 评估远程医疗对长效可逆避孕药 (LARC) 使用和巴氏涂片查率的影响.
主要方法:
- 一项回顾性队列研究分析了2020年7月至2023年6月期间接受产后护理的9953名个体的数据.
- 主要结局包括LARC使用和产后365天内帕普检查.
- 二次结局包括体重和血压评估,处方避孕药,初级保健访问和随后的怀孕.
主要成果:
- 与面对面的护理接受者相比,单独的远程医疗用户 (19.9%) 接受巴氏涂片查 (21.6%对40.1%) 和使用LARC (8.6%对19.4%) 的可能性明显低.
- 调整后的分析显示,在远程医疗中,巴氏涂抹 (OR 0.38) 和LARC使用 (OR 0.38) 的几率显著降低.
- 通过远程医疗观察到大多数次要结果的几率降低,除了在一年内随后怀孕.
结论:
- 调查结果表明,独家远程医疗产后护理与减少关键预防服务的使用率有关,如巴普查和LARC.
- 临床医生应仔细考虑推亲自进行分娩后检查,特别是对于缺乏强烈偏好或面临亲自护理接入障碍的患者.
- 远程医疗在产后护理中的作用需要制定战略,确保平等地获得必要的健康查和避孕措施.
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