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基层医疗中的跨专业协作与糖尿病管理:患者报告结局的系统评价与荟萃分析

Interprofessional Collaboration and Diabetes Management in Primary Care: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes.

作者信息

Nurchis Mario Cesare, Sessa Giorgio, Pascucci Domenico, Sassano Michele, Lombi Linda, Damiani Gianfranco

机构信息

Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

出版信息

J Pers Med. 2022 Apr 15;12(4):643. doi: 10.3390/jpm12040643.

Abstract

The global spread of diabetes poses serious threats to public health requiring a patient-centered approach based both on interprofessional collaboration (IPC) given by the cooperation of several different health professionals, and patients' perspective through the assessment of Patient-Reported Outcomes (PROs). The aim of the present study is to evaluate the impact of interprofessional collaboration interventions, for the management of type 2 diabetes in primary care settings, through PROs. A systematic review and meta-analysis was conducted querying the PubMed, Scopus and Embase databases. Out of the 1961 papers initially retrieved, 19 met the inclusion criteria. Interprofessional collaboration is significantly associated with an increase in both patient's satisfaction (SMD 0.32 95% CI 0.05-0.59) and in the mental well-being component of the HRQoL (SMD 0.18; 95% CI 0.06-0.30), and there was also promising evidence supporting the association between an interprofessional approach and an increase in self-care and in generic and specific quality-of-life. No statistical differences were found, supporting the positive impact on IPC interventions on the physical component of the HRQoL, depression, emotional distress, and self-efficacy. In conclusion, the effect of IPC impacts positively on the few areas assessed by PROMs. Policymakers should promote the widespread adoption of a collaborative approach as well as to endorse an active engagement of patients across the whole process of care.

摘要

糖尿病的全球蔓延对公众健康构成了严重威胁,这需要一种以患者为中心的方法,该方法既要基于由不同健康专业人员合作提供的跨专业协作(IPC),也要通过评估患者报告结局(PROs)来考虑患者的观点。本研究的目的是通过PROs评估跨专业协作干预对初级保健机构中2型糖尿病管理的影响。我们对PubMed、Scopus和Embase数据库进行了系统检索和荟萃分析。在最初检索到的1961篇论文中,有19篇符合纳入标准。跨专业协作与患者满意度的提高(标准化均数差[SMD] 0.32,95%置信区间[CI] 0.05 - 0.59)以及健康相关生活质量(HRQoL)的心理健康成分的提高(SMD 0.18;95% CI 0.06 - 0.30)显著相关,并且也有有力证据支持跨专业方法与自我护理以及一般和特定生活质量提高之间的关联。未发现统计学差异,这支持了IPC干预对HRQoL的身体成分、抑郁、情绪困扰和自我效能有积极影响。总之,IPC的效果对PROMs评估的少数领域有积极影响。政策制定者应促进广泛采用协作方法,并支持患者在整个护理过程中的积极参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/685c/9029958/b840e701f49a/jpm-12-00643-g001.jpg

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