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电子咨询对糖尿病护理的影响的系统审查
Elie Naous1, Angela Achkar1, Rebecca A Morin2
1Division of Internal Medicine, St. Elizabeth's Medical Center, Boston Medical Center Health System, Boston, Massachusetts.
概括
电子咨询 (e-consults) 显示出改善糖尿病护理的希望,特别是当内分泌学家稀缺时. 虽然电子咨询没有显著影响HbA1c水平,但可以提高药物使用和获得专家建议的机会.
科学领域:
- 内分泌学 在内分泌学.
- 数字健康数字健康
- 主要护理医学 医疗保健
背景情况:
- 由于内分泌学家短缺,初级保健医生 (PCP) 在管理糖尿病方面面临挑战.
- 电子咨询 (e-consults) 通过电子健康记录提供PCP和专家之间的异步通信.
- 电子咨询旨在改善对管理糖尿病等复杂疾病的专业专业知识的获取.
研究的目的:
- 系统地审查电子咨询对糖尿病患者血糖控制的影响.
- 评估HbA1c水平的变化作为主要结果.
- 确定与糖尿病护理中的电子咨询实施相关的好处和障碍.
主要方法:
- 系统审查遵循系统审查和元分析 (PRISMA) 2020年指南的首选报告项目.
- 搜索了包括PubMed,EMBASE和Cochrane图书馆在内的主要数据库.
- 包括随机对照试验和观察性研究,由两个独立审查员提取数据.
主要成果:
- 包括6项研究 (2项RCT,4项观察性).
- 大多数研究都没有发现电子咨询和对照组之间的HbA1c水平有显著差异.
- 观察到的好处包括改善药物管理,降低成本,加强专家访问,缩短等待时间和改善PCP教育.
结论:
- 电子咨询为糖尿病管理提供了显著的好处,特别是在资源有限的环境中.
- 他们提出了一个可行的解决方案,以解决内分泌学家短缺的问题.
- 需要进一步的研究来确定哪些患者群体从电子咨询中获益最多.
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