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[2型糖尿病降血糖药物处方中基层医疗服务继续医学教育项目评估]

[An evaluation of a continuing medical education program for primary care services in the prescription of hypoglycemic agents in diabetes mellitus type 2].

作者信息

Castro-Ríos Angélica, Reyes-Morales Hortensia, Pérez-Cuevas Ricardo

机构信息

Unidad de Investigación en Economía de la Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, D.F, México.

出版信息

Salud Publica Mex. 2008;50 Suppl 4:S445-52. doi: 10.1590/s0036-36342008001000005.

Abstract

OBJECTIVE

To evaluate the impact of a continuing medical education program on family doctors to improve prescription of hypoglycemic drugs.

MATERIAL AND METHODS

An observational study was conducted with two groups of comparison (with-without program) and before-after periods. The unit of analysis was the visit. The period of evaluation comprised six months before and six after implementing the program. The outcome variable was the appropriateness of prescription that was based upon two criteria: appropriate selection and proper indication of the drug. Logistic regression models and the double differences technique were used to analyze the information. Models were adjusted by independent variables related with the patient, the visit and the PCC, the more relevant ones were: sex, obesity, conditions other than diabetes, number of visits in the analyzed period, number of drugs prescribed, size of the PCC and period.

RESULTS

the program increases 0.6% the probability of appropriate prescription and 11% the probability of appropriate choice of the hypoglycemic drug in obese patients.

摘要

目的

评估一项针对家庭医生的继续医学教育项目对改善降糖药物处方的影响。

材料与方法

进行了一项观察性研究,设有两组对照(有项目组和无项目组),并划分了项目实施前后两个阶段。分析单位为就诊情况。评估期包括项目实施前六个月和实施后六个月。结果变量为处方的合理性,其基于两个标准:药物的恰当选择和正确指征。采用逻辑回归模型和双重差分技术对信息进行分析。模型通过与患者、就诊情况和基层医疗中心相关的自变量进行调整,其中较为相关的自变量有:性别、肥胖、糖尿病以外的疾病、分析期内的就诊次数、所开药物数量、基层医疗中心规模和时间段。

结果

该项目使肥胖患者处方合理的概率提高了0.6%,降糖药物选择恰当的概率提高了11%。

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