现实世界的实施和对失眠的数字CBT对医疗保健利用的影响:一种倾向匹配的受控研究
Christopher B Miller1,2, Danielle Bradley1,2, Ian Wood1,2
1Clinical Affairs, Big Health Ltd., London, UK.
Implementation research and practice
|November 3, 2025
概括
失眠的数字认知行为疗法 (CBT-I) 在现实世界的美国临床环境中成功减少了药物使用. 这种数字化方法改善了患者的治疗结果,同时无地融入了现有的医疗保健工作流程.
科学领域:
- 数字健康干预措施 数字健康干预措施
- 实施科学 实施科学
- 医疗保健系统研究研究
背景情况:
- 慢性失眠障碍影响10-15%的成年人,造成重大负担.
- 建议对失眠进行认知行为疗法 (CBT-I),但使用方法有限.
- 数字CBT-I提供了一个可扩展的解决方案,但实际的美国数据很少.
研究的目的:
- 评估数字CBT-I在美国临床环境中的实际实施和影响.
- 评估数字CBT-I对医疗保健利用的影响.
- 使用规范化过程理论 (NPT) 指导数字CBT-I的整合.
主要方法:
- 采用了一种倾向匹配的观察性研究设计.
- 通过订单率,患者注册和工作流程可接受性来评估实施情况.
- 分析了医疗保健利用率,将数字CBT-I用户与标准护理对照进行了比较.
主要成果:
- 数字CBT-I成功实施,有1,162名患者接受了这种干预.
- 数字CBT-I用户的药物填充量减少了64% (p < .001),失眠药物处方减少了53% (p = .013).
- 门诊访问最初增加,但随着时间的推移显示持续减少28-31%.
结论:
- 规范化过程理论促进了数字CBT-I的无集成.
- 数字CBT-I有效地减少了对药物的依赖,并改变了医疗保健利用模式.
- 提供者培训和提醒是成功接受和整合患者的关键.
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