低收入和中等收入国家的共同长期条件的自我管理干预措施:当前证据的综合
Taim Akhal1, Margherita Gabra1, Miriam Adesokan1
1The West African Institute for Applied Health Research (WAFERs), Ibadan, Oyo State, Nigeria.
Journal of global health
|May 23, 2025
概括
自主管理 (SM) 教育对改善低收入和中等收入国家 (LMICs) 的结果显示出希望. 基于社区的支持和指导干预对长期条件 (LTC) 有效,但需要更多的数据来做出政策决策.
科学领域:
- 全球健康 全球健康
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
背景情况:
- 低收入和中等收入国家 (LMICs) 面临着传染病和非传染病 (NCDs) 的双重负担.
- 非传染性疾病 (NCD) 在LMICs中呈现出日益严重的危机,使资源贫困的卫生系统承受着压力.
- 建议支持自我管理 (SM) 改善患者长期条件 (LTC) 的结果,但LMICs的证据有限.
研究的目的:
- 系统地审查和综合关于低收入和中等收入国家 (LMICs) 长期疾病患者 (LTCs) 自主管理 (SM) 干预措施有效性的证据.
- 确定特定类型的SM干预措施及其对临床,生活质量和经济结果的影响.
- 在资源有限的环境中为管理LTC提供政策和临床指南.
主要方法:
- 进行了系统审查和证据综合,搜索了七个数据库.
- 配对审查人员进行了研究选择,方法质量评估和数据提取.
- 包括报告有关疾病特异性结果的研究,如糖化血红蛋白 (HbA1c),生活质量 (QoL) 和经济措施.
主要成果:
- 26项研究 (包括试验,定性和综述) 分析了糖尿病,高血压和关节炎的干预措施.
- 自主管理 (SM) 教育在临床结果 (例如,HbA1c,血压),功能能力和生活质量 (QoL) 中表现出了最有前途的改善.
- 干预的有效性取决于识字能力,分娩辅助工具,并优先考虑面对面的互动教育课程而不是虚拟支持.
结论:
- 社区支持的指导性SM干预显示出改善LMIC中LTC结果的潜力.
- 缺乏成本可行性数据和结果的变化阻碍了可扩展性和政策决策.
- 制定临床指导方针和推广定制的SM教育对于LMICs的LTC管理至关重要.
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