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转诊至记忆评估服务机构后健康相关生活质量的变化。

Change in Health-related Quality of Life After Referral to Memory Assessment Services.

作者信息

Park Min Hae, Smith Sarah C, Chrysanthaki Theopisti, Neuburger Jenny, Ritchie Craig W, Hendriks A A Jolijn, Black Nick

机构信息

*Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London †School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey ‡Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK.

出版信息

Alzheimer Dis Assoc Disord. 2017 Jul-Sep;31(3):192-199. doi: 10.1097/WAD.0000000000000190.

Abstract

Despite strong support for the provision of memory assessment services (MASs) in England and other countries, their effectiveness in improving patient outcomes is uncertain. We aimed to describe change in patients' health-related quality of life (HRQL) 6 months after referral to MASs and to examine associations with patient characteristics and use of postdiagnostic interventions. Data from 883 patients referred to 69 MASs and their informal caregivers (n=569) were collected at referral and 6 months later. Multivariable linear regression was used to examine associations of change in HRQL (DEMQOL, DEMQOL-Proxy) with patient characteristics (age, sex, ethnicity, socioeconomic deprivation, and comorbidity) and use of postdiagnostic interventions (antidementia medications and nonpharmacological therapies). Mean HRQL improved, irrespective of diagnosis: self-reported HRQL increased 3.4 points (95% CI, 2.7-4.1) and proxy-reported HRQL 1.3 points (95% CI, 0.5-2.1). HRQL change was not associated with any of the patient characteristics studied. Patients with dementia (54%) receiving antidementia drugs reported greater improvement in their HRQL but those using nonpharmacological therapies reported less improvement compared with those note receiving therapy. HRQL improved in the first 6 months after referral to MASs. Research is needed to determine longer term sustainability of the benefits and the cost-effectiveness of MASs.

摘要

尽管在英格兰和其他国家,记忆评估服务(MASs)的提供获得了大力支持,但其在改善患者预后方面的有效性仍不确定。我们旨在描述患者转诊至记忆评估服务机构6个月后其健康相关生活质量(HRQL)的变化,并研究其与患者特征及诊断后干预措施使用情况之间的关联。在转诊时及6个月后,收集了883名转诊至69个记忆评估服务机构的患者及其非正式照料者(n = 569)的数据。采用多变量线性回归分析来研究健康相关生活质量的变化(DEMQOL、DEMQOL-Proxy)与患者特征(年龄、性别、种族、社会经济剥夺程度和合并症)以及诊断后干预措施的使用情况(抗痴呆药物和非药物治疗)之间的关联。无论诊断结果如何,平均健康相关生活质量均有所改善:自我报告的健康相关生活质量提高了3.4分(95%置信区间,2.7 - 4.1),他人报告的健康相关生活质量提高了1.3分(95%置信区间,0.5 - 2.1)。健康相关生活质量的变化与所研究的任何患者特征均无关联。接受抗痴呆药物治疗的痴呆患者(54%)报告其健康相关生活质量有更大改善,但与未接受治疗的患者相比,使用非药物治疗的患者报告的改善程度较小。转诊至记忆评估服务机构后的前6个月,健康相关生活质量有所改善。需要开展研究以确定这些益处的长期可持续性以及记忆评估服务的成本效益。

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