Lall Dorothy, Prabhakaran Dorairaj
Centre for chronic Disease Control, Delhi, India.
Expert Rev Cardiovasc Ther. 2014 Aug;12(8):987-95. doi: 10.1586/14779072.2014.928591. Epub 2014 Jun 17.
Chronic non-communicable diseases, predominantly diabetes and cardiovascular disease are a major public health problem globally. The chronicity of these diseases necessitates a restructuring of healthcare to address the multidisciplinary, sustained care including psychosocial support and development of self-management skills. Primary healthcare with elements of the chronic-care model provides the best opportunity for engagement with the health system. In this review, the authors discuss aspects of primary healthcare for management of diabetes and hypertension and innovations such as mobile-phone messaging, web-based registries, computer-based decision support systems and multifaceted health professionals in the care team among others that are being tested to improve the quality of care for these diseases in high, middle and low-income countries. The goal of quality care for diabetes and hypertension demands innovation within the realities of health systems both in high as well as low and middle-income countries.
慢性非传染性疾病，主要是糖尿病和心血管疾病，是全球主要的公共卫生问题。这些疾病的慢性特点使得医疗保健需要进行重组，以提供涵盖多学科的持续护理，包括心理社会支持和自我管理技能的培养。具备慢性病护理模式要素的初级医疗保健为与卫生系统的接触提供了最佳机会。在本综述中，作者讨论了糖尿病和高血压管理的初级医疗保健方面，以及诸如手机短信、基于网络的登记系统、基于计算机的决策支持系统和护理团队中的多方面健康专业人员等正在进行测试的创新措施，这些措施旨在提高高、中、低收入国家对这些疾病的护理质量。糖尿病和高血压优质护理的目标要求在高收入以及低收入和中等收入国家的卫生系统实际情况下进行创新。
