重新思考地带:在初级保健中取消低价值实践的实施
Katrina E Donahue1,2, Marcella H Boynton3, Jennifer Leeman4
1Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kdonahue@med.unc.edu.
BMC primary care
|April 4, 2025
概括
在2型糖尿病 (T2DM) 中,停止实施血糖自我监测 (SMBG) 在初级保健中是可行的. 虽然SMBG处方减少了,但"重新思考条纹"干预措施的影响有限,特别是在新诊断的患者身上.
科学领域:
- 初级保健研究研究初级保健研究
- 糖尿病管理 糖尿病管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对大多数非胰岛素治疗的2型糖尿病 (T2DM) 患者来说,血糖自我监测 (SMBG) 的价值有限.
- 重新思考条带 (RTS) 倡议旨在将SMBG在非胰岛素T2DM患者的初级保健中取消实施.
研究的目的:
- 评估RTS多元件撤销战略的有效性和实施情况.
- 评估SMBG处方实践在初级保健机构的变化.
主要方法:
- 在20个干预诊所和34个初级保健诊所中采用了前后研究设计.
- 退出实施策略在12个月内实施,随着18个月的随访期.
主要成果:
- 观察到接受糖尿病检测用品处方的几率总体下降 (OR 0.96).
- 在干预和比较诊所之间没有发现处方率的统计学上显著差异.
- 在对新诊断或新分配的患者的敏感性分析中,观察到一个小的干预效应 (OR 0.97).
结论:
- 在初级保健实践中,取消SMBG的实施是可行的.
- 该RTS策略表现出有限的有效性,可能受到COVID-19大流行和基线处方率等外部因素的影响.
- 新诊断或新患者可能代表一个更容易接受SMBG取消实施努力的人群.
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