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患者报告结局测量的常规使用能否改善以患者为中心的糖尿病护理的提供?近期进展回顾和案例研究。

Can the Routine Use of Patient-Reported Outcome Measures Improve the Delivery of Person-Centered Diabetes Care? A Review of Recent Developments and a Case Study.

机构信息

Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Aalborg, Denmark.

出版信息

Curr Diab Rep. 2019 Aug 16;19(9):84. doi: 10.1007/s11892-019-1190-x.

Abstract

PURPOSE OF REVIEW

In recent years, the recommendation for and use of patient-reported outcome measures (PROMs) in routine diabetes care has significantly increased. We review recent evidence and highlight key opportunities and challenges related to the active clinical use of PROMs to support person-centered diabetes care and focus areas for future research in the area.

RECENT FINDINGS

Recent pragmatic studies support that integration of multi-dimensional PROMs for diabetes in clinical care as part of a care improvement strategy can be acceptable for and valued by people with diabetes (PWD) and healthcare professionals (HCPs) and may improve multiple aspects of quality of care, including screening, medical care monitoring and decision support, individualization of self-management support and goal-setting, and broader benefits related to active patient participation and person-centred diabetes care. We identify multiple intervention, individual, and care setting characteristics, which influence acceptability, feasibility, implementation, and effectiveness of PROMs in routine care. Recent clinical PROM studies highlight the value of mixed methods research and systematic involvement of PWD, clinicians, and other stakeholders in the design and implementation of questionnaires for patient input in routine diabetes care. We identified a new significant trend towards participatory development of multi-dimensional PROMs with the aim of IT-enabled integration into routine diabetes care to facilitate multiple components of person-centered diabetes care and better clinical, quality of life, and cost outcomes. While results from large-scale randomized controlled studies are still limited, a growing number of pragmatic implementation studies support that user-centric PROM interventions have the potential to facilitate significant improvements in care for PWD.

摘要

目的综述

近年来,在常规糖尿病护理中推荐并使用患者报告结局测量(PROM)的做法显著增加。我们回顾了最新的证据,并强调了与积极使用 PROM 支持以患者为中心的糖尿病护理相关的关键机遇和挑战,以及该领域未来研究的重点。

最近发现

最近的实用研究支持,将多维糖尿病 PROM 整合到临床护理中,作为护理改善策略的一部分,对于糖尿病患者(PWD)和医疗保健专业人员(HCP)来说是可以接受和有价值的,并且可能改善多个方面的护理质量,包括筛查、医疗监测和决策支持、自我管理支持和目标设定的个体化,以及与积极的患者参与和以患者为中心的糖尿病护理相关的更广泛的获益。我们确定了多个干预、个体和护理环境特征,这些特征影响了 PROM 在常规护理中的可接受性、可行性、实施和有效性。最近的临床 PROM 研究强调了混合方法研究和系统地让 PWD、临床医生和其他利益相关者参与问卷设计和实施的价值,以便为常规糖尿病护理中的患者提供输入。我们发现了一个新的重要趋势,即多维 PROM 的参与式开发,旨在通过 IT 实现整合到常规糖尿病护理中,以促进以患者为中心的糖尿病护理的多个组成部分,并获得更好的临床、生活质量和成本结果。虽然来自大规模随机对照研究的结果仍然有限,但越来越多的实用实施研究支持以患者为中心的 PROM 干预有可能显著改善 PWD 的护理。

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