健康预测服务能否为 COPD 患者提供一种管理病情的新方法?

Can a health forecasting service offer COPD patients a novel way to manage their condition?

机构信息

Met Office, Exeter, UK.

出版信息

J Health Serv Res Policy. 2010 Jul;15(3):150-5. doi: 10.1258/jhsrp.2009.009035. Epub 2010 May 7.

Abstract

OBJECTIVES

The UK Meteorological Office (Met Office) has developed a health forecasting service for chronic obstructive pulmonary disease (COPD) patients, combining a rule-based model predicting risk based on environmental conditions with an anticipatory care intervention providing information on self-management and warnings via an interactive telephone call. Our aim was to explore the acceptability and utility of such a service to patients with COPD and its perceived impact on their behaviour and disease management.

METHODS

A cross-sectional questionnaire survey of service users drawn from 189 general practices in England, Scotland and Wales at the end of the winter of 2007/8.

RESULTS

Completed questionnaires were received from 3288 COPD patients, representing a response rate of 40%. Eighty-five percent of those returning a questionnaire reported at least one exacerbation during the study period and 8% had been admitted to hospital on one occasion or more. The majority of respondents deemed the information pack (comprising a booklet and thermometers) useful while the automated calls were generally said to be convenient, easy to understand and reassuring. Those less satisfied with the service felt they were already sufficiently aware of the prevailing weather conditions or felt more detailed information was needed. Most benefit was reported by those patients who were willing to be pro-active in the management of their condition, with the service encouraging 36% of respondents to seek a repeat prescription, 28% to re-read their information pack and 12% to consult their GP for worsening of symptoms.

CONCLUSIONS

Patients found the automated interactive calling, combined with a health risk forecast, both viable and useful, welcoming the information and tools it offered. In many cases, it added to patients' understanding of their illness and promoted better self-management. Future research should focus on the potential impact of the service in terms of health outcomes and cost-effectiveness.

摘要

目的

英国气象局(气象局)开发了一种针对慢性阻塞性肺疾病(COPD)患者的健康预测服务,该服务结合了基于环境条件预测风险的规则模型和通过互动电话提供自我管理信息和预警的预期护理干预措施。我们的目的是探索这种服务对 COPD 患者的可接受性和实用性,以及它对患者行为和疾病管理的感知影响。

方法

在 2007/8 年冬季结束时,对来自英格兰、苏格兰和威尔士的 189 家普通诊所的服务使用者进行了横断面问卷调查。

结果

共收到 3288 名 COPD 患者的完整问卷,应答率为 40%。85%的应答者在研究期间报告至少有一次加重,8%的人曾因一次或多次住院。大多数应答者认为信息包(包括小册子和温度计)有用,而自动电话通常被认为方便、易懂且令人安心。对服务不满意的人认为他们已经充分了解当前的天气状况,或者需要更详细的信息。那些愿意积极主动地管理自己病情的患者报告受益最大,该服务鼓励 36%的应答者再次开处方,28%的人重新阅读信息包,12%的人因症状恶化而咨询他们的 GP。

结论

患者发现自动互动电话加上健康风险预测既可行又有用,欢迎它提供的信息和工具。在许多情况下,这增加了患者对自己疾病的理解,并促进了更好的自我管理。未来的研究应侧重于该服务在健康结果和成本效益方面的潜在影响。

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