实施德国临床实践指南的多病症使用数字工具在初级保健:试点集群随机临床试验
Julia Nothacker1, Valentina Paucke1, Susanne Lezius2
1Institute and Outpatients Clinic of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
JMIR aging
|November 20, 2025
概括
使用数字工具实施用于多病症的临床实践指南是可行的. 这种方法可以减少住院和专家访问,同时提高老年患者的护理质量.
科学领域:
- 医疗信息学 医疗信息学
- 老年医学 老年医学
- 基于证据的实践.
背景情况:
- 临床实践指南 (CPG) 对于总结证据至关重要,但需要有效实施.
- 信息和通信技术可以帮助CPG实施,以改善以患者为中心的结果.
- 关于实施多病症CPG的研究,特别是使用数字工具的研究,是有限的.
研究的目的:
- 通过数字工具评估通过数字工具实施多病态性CPG的可行性.
- 探索这个数字化CPG实施干预措施的潜在影响.
主要方法:
- 一个试点集群随机试验,涉及120名老年患者 (≥65岁) 在20家全科医生 (GP) 实践中至少有两种慢性疾病.
- 一个网络应用程序的比较,用于CPG的遵守与通常的待遇.
- 主要结果:住院时间;次要结果:住院人数,医疗保健利用率,生活质量,患者满意度和护理质量.
主要成果:
- 实施是可行的,合规率为89%.
- 在干预组中,住院几率降低了近一半 (OR0.51,P=.23).
- 患者和全科医生报告的护理质量的改善 (分别P=.12和P=.03).
结论:
- 实现多病态性CPG的数字工具实现是可行的.
- 潜在的好处包括减少住院,减少专家访问和提高护理质量.
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