Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University, Lanxi Branch (Lanxi People's Hospital), Zhejiang, China.
Department of Respiratory and Critical Care Medicine, Zhejiang Medical and Health Group Hangzhou Hospital, Zhejiang, China.
Can Respir J. 2022 Jun 27;2022:6748330. doi: 10.1155/2022/6748330. eCollection 2022.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Strategies involving multidimensional approaches for the treatment of COPD are needed. This study aimed to evaluate the efficiency of medical consortium-based management for COPD. Patients were grouped in accordance with whether the hospitals they went to were under the medical consortium. We enrolled 141 COPD patients in the management group and 147 COPD patients in the control group. There was no predetermined sex and disease severity inclusion or exclusion criteria. Patients in the control group were managed by standard care, while patients in the management group were managed with intensive medical intervention jointly by specialists in the hospital and general practitioners and healthcare workers in community health centers. There was no difference in the basal demographics between the two groups. The basal condition of the management group was worse than that of the control group, demonstrated by a higher CAT score and a lower pulmonary function index. Half-year intensive intervention decreased CAT score from 17.28 to 15.62 and the Barthel ADL index from 73 to 60 in the management group, which was associated with better pulmonary rehabilitation, pursed-lip breathing, oxygen usage, and medicine regularity. The benefits became more obvious after one-year intensive intervention in the management group. There was a difference in mMRC grades and smoking cessation between the two groups. This study shows that a one-year intensive intervention improves the patients' health status and pulmonary function, suggesting that our medical consortium-based management is effective in the treatment of COPD.
慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因。需要涉及 COPD 多维治疗方法的策略。本研究旨在评估基于医疗联盟的 COPD 管理的效率。根据患者就诊的医院是否属于医疗联盟，将患者分为两组。我们将 141 例 COPD 患者纳入管理组，147 例 COPD 患者纳入对照组。没有预先确定的性别和疾病严重程度纳入或排除标准。对照组患者接受标准护理，而管理组患者接受由医院专家和社区卫生中心的全科医生和卫生工作者共同进行的强化医疗干预。两组之间的基础人口统计学特征没有差异。管理组的基础情况比对照组差，表现在 CAT 评分较高和肺功能指数较低。半年强化干预使管理组的 CAT 评分从 17.28 降至 15.62，Barthel ADL 指数从 73 降至 60，这与更好的肺康复、缩唇呼吸、氧气使用和药物规律有关。管理组在经过一年的强化干预后，效果更加明显。两组间在 mMRC 分级和戒烟方面存在差异。本研究表明，一年的强化干预改善了患者的健康状况和肺功能，提示我们基于医疗联盟的管理在 COPD 的治疗中是有效的。
