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如何设计和评估干预措施以改善患有多种疾病的患者的治疗效果。

How to design and evaluate interventions to improve outcomes for patients with multimorbidity.

作者信息

Smith Susan M, Bayliss Elizabeth A, Mercer Stewart W, Gunn Jane, Vestergaard Mogens, Wyke Sally, Salisbury Chris, Fortin Martin

机构信息

HRB Centre for Primary Care Research, Department of General Practice, RCSI Medical School, Dublin, Ireland.

Kaiser Permanent Colorado and University of Colorado, Denver, Colorado, CO, USA.

出版信息

J Comorb. 2013 Oct 8;3:10-17. doi: 10.15256/joc.2013.3.21. eCollection 2013.

Abstract

Multimorbidity is a major challenge for patients and healthcare providers. The limited evidence of the effectiveness of interventions for people with multimorbidity means that there is a need for much more research and trials of potential interventions. Here we present a consensus view from a group of international researchers working to improve care for people with multimorbidity to guide future studies of interventions. We suggest that there is a need for careful consideration of whom to include, how to target interventions that address specific problems and that do not add to treatment burden, and selecting outcomes that matter both to patients and the healthcare system. Innovative design of these interventions will be necessary as many will be introduced in service settings and it will be important to ensure methodological rigour, relevance to service delivery, and generalizability across healthcare systems. Journal of Comorbidity 2013;3:10-17.

摘要

共病对患者和医疗服务提供者来说是一项重大挑战。针对患有多种疾病的人群,干预措施有效性的证据有限,这意味着需要开展更多关于潜在干预措施的研究和试验。在此,我们展示了一组致力于改善对患有多种疾病人群护理的国际研究人员的共识观点,以指导未来干预措施的研究。我们建议,需要仔细考虑纳入哪些人群、如何针对解决特定问题且不会增加治疗负担的干预措施,以及选择对患者和医疗系统都重要的结果。这些干预措施需要进行创新性设计,因为许多措施将在服务环境中实施,确保方法的严谨性、与服务提供的相关性以及在不同医疗系统中的可推广性非常重要。《共病杂志》2013年;3:10 - 17。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6711/5636021/3347ec111bfd/joc-03-010-g001.jpg

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