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使用信息管理系统提高门诊糖尿病护理质量:观察性VISION研究的结果

Improving the Quality of Outpatient Diabetes Care Using an Information Management System: Results From the Observational VISION Study.

作者信息

Weissmann Joerg, Mueller Angelika, Messinger Diethelm, Parkin Christopher G, Amann-Zalan Ildiko

机构信息

Roche Diagnostics Deutschland GmbH, Mannheim, Germany.

Biometrics Department, IST GmbH, Mannheim, Germany.

出版信息

J Diabetes Sci Technol. 2015 Jul 29;10(1):76-84. doi: 10.1177/1932296815595984.

Abstract

BACKGROUND

This study aimed to evaluate the effects of information management system (IMS) use with individuals with type 1 and type 2 diabetes who were treated in outpatient settings.

METHODS

In this 7-month, prospective, observational study, 965 adults with diabetes, mean (SD) baseline HbA1c 8.61(1.2)% (70.6[13.1] mmol/mol), were recruited from 132 outpatient care centers in Germany and Denmark. HbA1c was measured at baseline, month 4, and month 7. IMS reports were generated from uploaded self-monitored blood glucose data and therapy adjustments were documented at months 1 and 4. Hypoglycemic events were documented.

RESULTS

Mean (SD) HbA1c decreased from baseline in type 1 and type 2 diabetes patients at month 4 (-0.61[1.03]% (-6.7[11.3] mmol/mol), n = 213; -0.88[1.22]% (-9.6[13.3] mmol/mol), n = 589, respectively) and month 7 (-0.64[1.02]% (-7.0[11.1] mmol/mol), n = 219; -0.93[1.27]% (-10.2[13.9] mmol/mol), n = 594, respectively), all P < .0001, with no increase in hypoglycemic events. Therapy was adjusted in 106(42.7)% type 1 and 349(52.4)% type 2 diabetes patients at months 1 and 105(42.3)% type 1 and 282(42.3)% type 2 diabetes patients at month 4. Physicians used IMS reports to make therapy adjustments in 90% of patients at month 1 and 86% of patients at month 4.

CONCLUSIONS

Integration of the IMS into outpatient care facilitates significant improvements in glycemic control.

摘要

背景

本研究旨在评估信息管理系统(IMS)在1型和2型糖尿病门诊患者中的应用效果。

方法

在这项为期7个月的前瞻性观察性研究中,从德国和丹麦的132个门诊护理中心招募了965名成年糖尿病患者,其平均(标准差)基线糖化血红蛋白(HbA1c)为8.61(1.2)%(70.6[13.1] mmol/mol)。在基线、第4个月和第7个月测量HbA1c。根据上传的自我监测血糖数据生成IMS报告,并在第1个月和第4个月记录治疗调整情况。记录低血糖事件。

结果

1型和2型糖尿病患者的平均(标准差)HbA1c在第4个月时从基线水平下降(分别为-0.61[1.03]%(-6.7[11.3] mmol/mol),n = 213;-0.88[1.22]%(-9.6[13.3] mmol/mol),n = 589),在第7个月时也下降(分别为-0.64[1.02]%(-7.0[11.1] mmol/mol),n = 219;-0.93[1.27]%(-10.2[13.9] mmol/mol),n = 594),所有P <.0001,且低血糖事件没有增加。在第1个月,106名(42.7%)1型糖尿病患者和349名(52.4%)2型糖尿病患者的治疗进行了调整;在第4个月,105名(42.3%)1型糖尿病患者和282名(42.3%)2型糖尿病患者的治疗进行了调整。在第1个月,90%的患者医生使用IMS报告进行治疗调整;在第4个月,86%的患者医生使用IMS报告进行治疗调整。

结论

将IMS整合到门诊护理中有助于显著改善血糖控制。

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