Aryani Faridah Md Yusof, Lee Shaun Wen Huey, Chua Siew Siang, Kok Li Ching, Efendie Benny, Paraidathathu Thomas
Pharmaceutical Services Division, Ministry of Health Malaysia, Petaling Jaya.
School of Pharmacy, Monash University Malaysia, Bandar Sunway.
Integr Pharm Res Pract. 2016 Jan 19;5:11-17. doi: 10.2147/IPRP.S92448. eCollection 2016.
Chronic diseases such as hypertension, diabetes mellitus, and hyperlipidemia are public health concerns. However, little is known about how these affect patient-level health measures. The aim of the study was to examine the impact of a chronic care model (CCM) on the participant's health-related quality of life (QoL).
Participants received either usual care or CCM by a team of health care professionals including pharmacists, nurses, dietitians, and general practitioners. The participants in the intervention group received medication counseling, adherence, and dietary advice from the health care team. The QoL was measured using the EQ-5D (EuroQoL-five dimension, health-related quality of life questionnaire) and comparison was made between usual care and intervention groups at the beginning and end of the study at 6 months.
Mean (standard deviation) EQ-5D index scores improved significantly in the intervention group (0.92±0.10 vs 0.95±0.08; ≤0.01), but not in the usual care group (0.94±0.09 vs 0.95±0.09; =0.084). Similarly, more participants in the intervention group reported improvements in their QoL compared with the usual care group, especially in the pain/discomfort and anxiety/depression dimensions.
The implementation of the CCM resulted in significant improvement in QoL. An interdisciplinary team CCM approach should be encouraged, to ultimately result in behavior changes and improve the QoL of the patients.
高血压、糖尿病和高脂血症等慢性病是公共卫生关注的问题。然而,对于这些疾病如何影响患者层面的健康指标,人们知之甚少。本研究的目的是检验慢性病护理模式(CCM)对参与者健康相关生活质量(QoL)的影响。
参与者接受由包括药剂师、护士、营养师和全科医生在内的医疗专业人员团队提供的常规护理或CCM。干预组的参与者接受了医疗团队提供的用药咨询、依从性和饮食建议。使用EQ-5D(欧洲五维度健康相关生活质量问卷)测量生活质量,并在研究开始时和6个月研究结束时对常规护理组和干预组进行比较。
干预组的平均(标准差)EQ-5D指数得分显著提高(0.92±0.10对0.95±0.08;P≤0.01),而常规护理组则未提高(0.94±0.09对0.95±0.09;P = 0.084)。同样,与常规护理组相比,干预组中有更多参与者报告其生活质量有所改善,尤其是在疼痛/不适和焦虑/抑郁维度。
CCM的实施导致生活质量显著提高。应鼓励采用跨学科团队CCM方法,以最终促成行为改变并改善患者的生活质量。