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一套标准的以患者为中心的糖尿病结局评估指标:国际统一方法的研究结果。

A standard set of person-centred outcomes for diabetes mellitus: results of an international and unified approach.

机构信息

Institute of Epidemiology, Helmholtz Zentrum-Munich, German Research Centre for Environmental Health, Munich, Germany.

German Centre for Diabetes Research, Munich, Germany.

出版信息

Diabet Med. 2020 Dec;37(12):2009-2018. doi: 10.1111/dme.14286. Epub 2020 Mar 20.

Abstract

AIMS

To select a core list of standard outcomes for diabetes to be routinely applied internationally, including patient-reported outcomes.

METHODS

We conducted a structured systematic review of outcome measures, focusing on adults with either type 1 or type 2 diabetes. This process was followed by a consensus-driven modified Delphi panel, including a multidisciplinary group of academics, health professionals and people with diabetes. External feedback to validate the set of outcome measures was sought from people with diabetes and health professionals.

RESULTS

The panel identified an essential set of clinical outcomes related to diabetes control, acute events, chronic complications, health service utilisation, and survival that can be measured using routine administrative data and/or clinical records. Three instruments were recommended for annual measurement of patient-reported outcome measures: the WHO Well-Being Index for psychological well-being; the depression module of the Patient Health Questionnaire for depression; and the Problem Areas in Diabetes scale for diabetes distress. A range of factors related to demographic, diagnostic profile, lifestyle, social support and treatment of diabetes were also identified for case-mix adjustment.

CONCLUSIONS

We recommend the standard set identified in this study for use in routine practice to monitor, benchmark and improve diabetes care. The inclusion of patient-reported outcomes enables people living with diabetes to report directly on their condition in a structured way.

摘要

目的

选择一组用于国际常规应用的糖尿病核心标准结局,包括患者报告结局。

方法

我们对结局测量指标进行了系统的结构化综述,重点是 1 型或 2 型糖尿病的成年患者。在此过程之后,采用具有多学科学术、卫生专业人员和糖尿病患者的共识驱动的改良 Delphi 小组进行研究。向糖尿病患者和卫生专业人员征求了对结局测量指标集的外部反馈意见,以验证该套指标。

结果

小组确定了一组与糖尿病控制、急性事件、慢性并发症、卫生服务利用和生存相关的基本临床结局,这些结局可以使用常规行政数据和/或临床记录进行测量。建议使用三种工具来每年测量患者报告的结局指标:世界卫生组织心理健康幸福感量表;患者健康问卷的抑郁模块,用于测量抑郁;以及糖尿病困扰量表,用于测量糖尿病困扰。还确定了与人口统计学、诊断特征、生活方式、社会支持和糖尿病治疗相关的一系列因素,用于病例组合调整。

结论

我们建议在常规实践中使用本研究中确定的标准集来监测、基准和改善糖尿病护理。纳入患者报告的结局使患有糖尿病的人能够以结构化的方式直接报告他们的病情。

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