在初级保健中为尿失禁妇女进行自动查和教育
Sarah A Collins1, Julia Geynisman-Tan2, Lucia C Petito3
1Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, The University of Chicago Pritzker School of Medicine, Chicago, Illinois.
JAMA internal medicine
|February 9, 2026
概括
针对尿失禁 (UI) 的自动查和教育增加了诊断和骨盆底治疗和小专科护理的转诊. 这项质量改善倡议显示出改善妇女健康结果的前景.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 妇女健康 妇女健康
- 医疗信息学 医疗信息学
背景情况:
- 尿失禁 (UI) 是一种影响妇女生活质量的普遍疾病,但仍未得到充分报告和治疗.
- 早期识别和干预对于有效管理UI至关重要.
研究的目的:
- 评估自动化UI查和识别,教学和治疗 (IT2) 教育倡议在初级保健中的影响.
- 评估IT2实施后UI诊断率和骨盆底治疗和亚专科护理转诊率的变化.
主要方法:
- 一项质量改进研究,利用43个初级保健机构的电子健康记录 (EHR) 数据.
- 用细分线性回归进行中断时间序列分析,以比较UI诊断和治疗的UI诊断和治疗率.
- 包括72,009名在研究期间 (2023年1月1日至2024年12月1日) 提交年度访问的妇女.
主要成果:
- IT2倡议导致UI诊断的显著增加,每100次接触中立即增加0.51次 (P=.01) 和每100次接触中持续增加0.55次 (P=.03).
- 骨盆地物理治疗的转诊显示出类似的趋势,最初每100次治疗增加0.38次 (P<.001),年率增加每100次治疗增加0.31次 (P=.001).
- 推到子专业服务也在实施后显著增加 (0.29每100次接触,P<.001),而UI药物处方保持不变.
结论:
- 在初级保健机构中实施大规模的,自动化的UI查和教育计划是可行的.
- IT2倡议有效地提高了女性尿失禁的意识,诊断和治疗转诊率.
- 这种方法有可能改善女性UI的管理和结果.
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