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DIABETOLOGIA：对复杂2型糖尿病患者的初级和二级护理模型的临床结果

2019-04-04 不详 网络

二级护理
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<span style="font-size:12.0pt;font-family:宋体;mso-ascii-font-family: Calibri;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:宋体;mso-fareast-theme-font: minor-fareast;mso-hansi-font-family:Ca

本项研究的目的是确定一个利用全科医生(GPs)综合治疗的指导模型可以达到类似以医院为基础的糖尿病专科门诊的临床结果。

这项实用的非劣效多效体随机对照试验将复杂2型糖尿病患者按3:1的比例分配到Beacon诊所或医院门诊部进行常规治疗。由于研究的性质，研究人员只是在分配过程中单盲。符合条件的参加者年龄为18岁或以上，曾由其通常的全科医生转诊至医院中央转诊中心治疗2型糖尿病，并在分类观察30或90天。干预包括初级保健中的糖尿病管理，由全科医生负责在内分泌学家的监督下熟练掌握了复杂糖尿病的知识。主要结果为招募后12个月的糖化血红蛋白。非劣效差为4.4 mmol/mol(0.4%)。分析每个方案和意向治疗报告。

在2012年11月27日至2015年7月14日期间，我们招募了352名患者，其中305人是意向治疗样本(71人在常规护理组，234人在Beacon模型组)。信标模型对两种协议都不低于常规治疗(差值- 0.38 mmol/mol [95% CI - 4.72, 3.96];- 0.03% (95% CI - 0.43, 0.36)和治疗意愿(差值- 1.28 mmol/mol (95% CI - 5.96, 3.40);- 0.12% [95% CI - 0.55, 0.31])分析。非劣效性在12个月时进行敏感性分析。12项简易健康调查(SF-12v2)和糖尿病相关生活质量调查(DQoL-Brief)测量的血压、血脂、生活质量二级结果无统计学或临床显著差异。各组间的安全指标没有差异。两组患者对8项客户满意度问卷(CSQ-8)的满意度均较好，但Beacon模型组评分显著高于常规护理组(均值[SD] 28.4 [4.9] vs . 25.6 [4.9]，p < 0.001)。

在2型糖尿病患者中，由全科医生在社区内提供综合护理的模式可以安全地取得临床结果，而不低于那些以医院为基础的金标准专科门诊诊所的结果。在社区接受护理的个人满意度更高。进一步的研究将确定提供这种护理模式的成本。

原始出处：

Anthony W. Russell, Maria Donald, Clinical outcomes of an integrated primary–secondary model of care for individuals with complex type 2 diabetes: a non-inferiority randomised controlled trial

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    2019-06-19 ms9608593228839890

    #DIA#

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    #BET#

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    #临床结果#

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    2019-04-06 aids213

    #2型糖尿病患者#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1639067, encodeId=0369163906e2e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Wed Jun 19 19:31:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761077, encodeId=e33c1e6107781, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Mon Jun 17 14:31:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898824, encodeId=4fd01898824da, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Thu Jun 20 05:31:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383540, encodeId=e5ce1383540cf, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474726, encodeId=f47b14e47268a, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042358, encodeId=8cf21042358b0, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047691, encodeId=7cff104e6919d, content=梅斯里提供了很多疾病的模型计算公式，赞一个！, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
    2019-04-06 xue8604

    #糖尿病患者#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1639067, encodeId=0369163906e2e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Wed Jun 19 19:31:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761077, encodeId=e33c1e6107781, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Mon Jun 17 14:31:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898824, encodeId=4fd01898824da, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Thu Jun 20 05:31:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383540, encodeId=e5ce1383540cf, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474726, encodeId=f47b14e47268a, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042358, encodeId=8cf21042358b0, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047691, encodeId=7cff104e6919d, content=梅斯里提供了很多疾病的模型计算公式，赞一个！, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
    2019-04-05 misszhang

    谢谢MedSci提供最新的资讯

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1639067, encodeId=0369163906e2e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Wed Jun 19 19:31:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761077, encodeId=e33c1e6107781, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Mon Jun 17 14:31:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898824, encodeId=4fd01898824da, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Thu Jun 20 05:31:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383540, encodeId=e5ce1383540cf, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=13, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474726, encodeId=f47b14e47268a, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sat Apr 06 13:31:00 CST 2019, time=2019-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042358, encodeId=8cf21042358b0, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047691, encodeId=7cff104e6919d, content=梅斯里提供了很多疾病的模型计算公式，赞一个！, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Apr 05 01:31:00 CST 2019, time=2019-04-05, status=1, ipAttribution=)]
    2019-04-05 CHANGE

    梅斯里提供了很多疾病的模型计算公式，赞一个！

    0