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实施和评估最佳实践咨询,以减少1型糖尿病患者在技术使用中的不平等:混合方法,非随机对照试验的协议
Nestoras Mathioudakis1, Risa Wolf2, Abha Choudhary3
1Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States.
JMIR research protocols
|May 28, 2025
概括
本研究介绍了一项最佳实践咨询 (BPA),以减少高级糖尿病技术 (ADT) 用于1型糖尿病管理的种族差异. 该法案旨在规范处方,促进公平获取和改善所有患者的临床结果.
科学领域:
- 糖尿病 技术 技术
- 健康 公平 卫生 公平
- 临床信息学 临床信息学
背景情况:
- 持续血糖监测和自动胰岛素输送系统的进步改善了1型糖尿病的管理.
- 尽管有好处,但在采用和利用先进的糖尿病技术 (ADT) 方面仍然存在显著的种族不平等.
- 现有的差异影响了代表性不足的种族和民族群体的生活质量和血糖控制.
研究的目的:
- 开发和评估基于电子医疗记录 (EMR) 的最佳实践咨询 (BPA),旨在减轻ADT使用中的种族和民族差异.
- 通过EMR集成的BPA标准化ADT处方,假设减少1型糖尿病儿科和成人患者的差异.
- 在1型糖尿病患者的不同人群中,促进对ADT的公平获取和使用的进展.
主要方法:
- 减少技术使用不平等的最佳实践建议 (BPA-TECH) 研究采用非随机匹配对干预设计.
- 第1阶段涉及与医疗保健提供者和患者进行定性方法 (焦点小组,调查),以改进BPA.
- 第二阶段利用7个T1D交换质量改进协作 (T1DX-QI) 中心的受控前后研究,比较12个月的BPA部署前后.
主要成果:
- 该研究于2024年7月开始,从2024年8月开始收集定性数据;估计完成时间为2027年5月.
- 第二阶段预计将在干预中心招收大约3000名符合条件的非西班牙裔黑人和西班牙裔患者,并与15,000名对照进行匹配.
- 主要结局是ADT使用的进展;该研究的动力是检测群体之间主要终点实现的15%差异.
结论:
- 该BPA-TECH研究利用健康信息技术 (IT) 来解决1型糖尿病ADT使用的种族和民族差异.
- 通过BPA标准化ADT处方有潜力促进健康公平并改善糖尿病管理中的临床结果.
- 结果将指导未来的干预措施,旨在减少糖尿病技术采用和利用的医疗保健差异.
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