孕期糖尿病的PA诊所:一项观察性研究
Nikki Semaniuk1, Abigail Meadows, Pam Katz
1At the University of Manitoba in Winnipeg, Manitoba, Canada, Nikki Semaniuk is a clinical instructor for the Master of Physician Assistant Studies program; Abigail Meadows is a first-year medical resident; Pam Katz is an assistant professor in the Department of Internal Medicine and section head for the Section of Endocrinology; Sora Ludwig is a professor; Bruce Roe is an assistant professor of endocrinology and metabolism; Elizabeth Salamon is an assistant professor; Sarah M. Sigurdson is a first-year medical student; Katherine J. Bernier is a first-year medical student; Christy Pylypjuk is an associate professor and associate head of research in the Department of Obstetrics, Gynecology and Reproductive Sciences, as well as the assistant director of the Manitoba Obstetrical Outreach Program; and Jennifer M. Yamamoto is an assistant professor in the Department of Internal Medicine. Outside of the University of Manitoba, N. Semaniuk is an endocrinology PA at St. Boniface Hospital in Winnipeg; P. Katz is medical director of the Manitoba Adult Insulin Pump Program at Health Sciences Centre Winnipeg in Winnipeg; and J.M. Yamamoto is an adjunct assistant professor in the Department of Medicine at the University of Calgary in Calgary, Alberta, Canada. E. Salamon discloses receipt of monetary compensation from Novo Nordisk for educational sessions. C. Pylypjuk discloses receipt of grants to University of Manitoba and Health Sciences Centre Foundation for unrelated work. J.M. Yamamoto discloses receipt of devices for no or reduced cost from Abbott and Medtronic for investigator-initiated and publicly funded studies. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
医生助理领导的诊所有效地管理妊娠糖尿病,显示与医生领导的护理相比,母亲和新生儿的结果相似. 这个模型提供了一种安全有效的方法来管理这种常见的妊娠并发症.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 医疗保健管理的管理
背景情况:
- 孕期糖尿病 (GDM) 是一个常见的妊娠并发症.
- 管理GDM需要专门的专业知识和频繁的患者监测.
- 由于高GDM转诊率,现有的专科诊所面临重大压力.
研究的目的:
- 评估由医生助理 (PA) 领导的妊娠糖尿病诊所的安全性和有效性.
- 为了比较PA主导和医生主导的跨学科GDM诊所之间的结果.
主要方法:
- 使用了回顾性队列研究设计.
- 在PA领导的跨学科团队诊所和医生领导的跨学科团队诊所之间比较了结果.
- 根据患者特征差异进行了统计调整.
主要成果:
- 在调整后,在两种临床模型中,孕产妇和新生儿的结局是可比的.
- 在PA主导的诊所中,药物治疗的开始显着较低 (aOR 0.19;95% CI,0.11-0.31).
- 转诊选过程中的差异可能解释了药物治疗启动的减少.
结论:
- 医生助理可以有效地管理大量的妊娠糖尿病转诊情况.
- 由PA领导的模型表明,与由医生领导的管理相比,护理质量相当.
- 这种方法为GDM护理提供了安全有效的替代方案.
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