在初级保健中研究慢性喘息的结构化诊断方法:混合方法可行性集群随机对照试验
Gillian Doe1, Jill Clanchy2, Simon Wathall3
1NIHR Respiratory BRC Leicester, Department of Respiratory Sciences, University of Leicester, Leicester, UK.
BMJ open respiratory research
|February 13, 2025
概括
在初级保健中,慢性喘息的新诊断方法显示,它有望为更快的调查和诊断提供帮助. 这项可行性研究表明,这对患者有潜在的益处,因此需要进行更大的试验.
科学领域:
- 主要护理医学 医疗保健
- 诊断策略 诊断策略
- 慢性疾病管理 慢性疾病管理
背景情况:
- 慢性喘息诊断的延迟会对患者的治疗结果产生负面影响.
- 在初级保健机构中,急需改进诊断途径.
研究的目的:
- 评估一种结构化,基于症状的诊断方法在初级保健中治疗慢性喘息的可行性.
- 评估一个更大的集群随机对照试验 (cRCT) 对这一诊断策略的潜力.
主要方法:
- 一个混合方法可行性研究,涉及10名全科医生实践.
- 实践被随机分组为结构化诊断干预或常规护理.
- 主要结果包括招聘和保留率;次要结果包括调查,诊断和患者报告的结果措施 (PROM).
主要成果:
- 招聘率为32% (48/150),在一年后的留守率为85%.
- 干预组接受了更多的调查 (中位数为8个,而3个月后为5个).
- 在干预组中观察到更高的呼吸困难编码诊断率 (44%对1年26%),PROMs的潜在改善.
结论:
- 在初级保健中,慢性喘息的基于症状的诊断方法是可行的.
- 该方法显示了及时调查和诊断的潜力,可能改善患者报告的结果.
- 为进一步评估,建议使用带有健康经济分析的全功率cRCT.
关键词:
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