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整合医学初级保健试验(IMPACT)的真实世界证据:评估基线和12个月随访时患者报告的结局

Real-World Evidence from the Integrative Medicine Primary Care Trial (IMPACT): Assessing Patient-Reported Outcomes at Baseline and 12-Month Follow-Up.

作者信息

Crocker Robert L, Hurwitz Jason T, Grizzle Amy J, Abraham Ivo, Rehfeld Rick, Horwitz Randy, Weil Andrew T, Maizes Victoria

机构信息

Andrew Weil Center for Integrative Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.

Center for Health Outcomes & PharmacoEconomic Research (HOPE), College of Pharmacy, University of Arizona, Tucson, AZ, USA.

出版信息

Evid Based Complement Alternat Med. 2019 Jun 26;2019:8595409. doi: 10.1155/2019/8595409. eCollection 2019.

DOI:10.1155/2019/8595409
PMID:31346339
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6617880/
Abstract

PURPOSE

The University of Arizona Integrative Health Center (UAIHC) was an innovative membership-supported integrative medicine (IM) adult primary care clinic in Phoenix, Arizona. UAIHC delivered healthcare using an integrative medicine model that combined conventional and complementary medical treatments, including nutrition, mind-body medicine, acupuncture, manual medicine, health coaching, educational classes, and groups. Results from pre-post evaluation of patient-reported outcomes on several standardized measures are presented here.

METHODS

UAIHC patients completed surveys at baseline and after 12 months of continuous integrative primary care. Patients reported on perceived changes in health outcomes as measured by ( general, mental, and physical health), , , ), , , , for depression global rating of sleep quality, and the ; nutrition, exercise, and physical activity). Overall differences between time points were assessed for statistical significance. Patient demographics are also described.

RESULTS

177 patients completed baseline and follow-up outcome measures. Patients were predominantly white, female, college-educated, and employed. Baseline to one-year follow-up results indicate statistically significant improvements (.05) on all but perceived stress () and work absenteeism (). Clinical impact and/or practical effects are reported as percent change or standardized effect sizes whenever possible. Other demographic and descriptive information is summarized.

CONCLUSIONS

Following one year of IM primary care at UAIHC, patient-reported outcomes indicated positive impacts in several areas of patients' lives: mental, physical, and overall health; work productivity; sleep quality; pain; fatigue; overall well-being; and physical activity.

摘要

目的

亚利桑那大学综合健康中心(UAIHC)是亚利桑那州凤凰城一家创新型的由会员支持的综合医学(IM)成人初级保健诊所。UAIHC采用综合医学模式提供医疗服务,该模式将传统医学与补充医学治疗相结合,包括营养、身心医学、针灸、手法医学、健康指导、教育课程和团体活动。本文展示了对患者报告结局进行的几项标准化测量的前后评估结果。

方法

UAIHC的患者在基线时以及接受12个月持续综合初级保健后完成了调查。患者报告了通过 (总体、心理和身体健康)、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 来衡量的健康结局感知变化, 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 、 的抑郁情况,睡眠质量的总体评分,以及 ;营养、运动和身体活动)。评估了时间点之间的总体差异的统计学显著性。还描述了患者人口统计学特征。

结果

177名患者完成了基线和随访结局测量。患者主要为白人、女性、受过大学教育且有工作。从基线到一年随访的结果表明,除了感知压力( )和工作缺勤( )外,所有方面均有统计学显著改善( )。只要有可能,临床影响和/或实际效果均以百分比变化或标准化效应量报告。总结了其他人口统计学和描述性信息。

结论

在UAIHC接受一年的综合医学初级保健后,患者报告的结局表明对患者生活的几个方面产生了积极影响:心理、身体和整体健康;工作效率;睡眠质量;疼痛;疲劳;总体幸福感;以及身体活动。

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BMC Complement Altern Med. 2017 Nov 15;17(1):490. doi: 10.1186/s12906-017-1996-5.
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