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2020 年美国囊性纤维化患者接受 CF 护理和使用远程医疗的相关因素。

Factors associated with receiving CF care and use of telehealth in 2020 among persons with Cystic Fibrosis in the United States.

机构信息

Pediatrics, Johns Hopkins University, Baltimore, MD, United States.

Pulmonary and Critical Care Medicine, University of Virginia, Charlottesville, VA, United States.

出版信息

J Cyst Fibros. 2023 May;22(3):456-463. doi: 10.1016/j.jcf.2022.12.004. Epub 2022 Dec 14.

Abstract

BACKGROUND

The COVID-19 pandemic resulted in the use of telehealth to deliver the cystic fibrosis (CF) care model, which recommends routine follow-up for monitoring of nutritional status, bacterial culture surveillance, pulmonary function testing, and screening for CF-related complications such as diabetes or osteoporosis.

METHODS

The objective of this study was to use Cystic Fibrosis Foundation Patient Registry (CFFPR) data to quantify the extent to which persons with CF received the recommended components of the care model in 2019 versus 2020. A risk factor analysis was implemented to identify patient characteristics associated with attaining the recommended CF care and use of any telehealth using multivariable logistic regression.

RESULTS

A total of 28,132 CFFPR participants were included in the study. The proportion of individuals meeting the recommendations for CF care was lower in 2020 for every indicator, and lower in adults compared to children. In adults, demographic, socioeconomic and CF-related disease covariates were significantly associated with both achieving an aggregate level of care and use of telehealth. In the pediatric population, minority race/ethnicity and markers of lower socioeconomic status were associated with a lower odds of telehealth use. In all analyses, having received the recommended level of care in 2019 was associated with a higher odds of both reported telehealth use and achieving the recommended elements of the CF care model in 2020.

CONCLUSION

Fewer participants met recommendations for care in 2020 despite widespread use of telehealth, and use of telehealth did not equate to adherence to all aspects of CF care.

摘要

背景

COVID-19 大流行导致使用远程医疗来提供囊性纤维化 (CF) 护理模式,该模式建议进行常规随访,以监测营养状况、细菌培养监测、肺功能测试以及筛查 CF 相关并发症,如糖尿病或骨质疏松症。

方法

本研究的目的是使用囊性纤维化基金会患者登记处 (CFFPR) 数据来量化 2019 年与 2020 年之间 CF 患者接受护理模式推荐成分的程度。实施风险因素分析以确定与达到推荐的 CF 护理相关的患者特征,并使用多变量逻辑回归识别与任何远程医疗使用相关的特征。

结果

共有 28,132 名 CFFPR 参与者纳入本研究。在 2020 年,每一个指标的符合 CF 护理建议的个体比例都较低,并且成年人比儿童的比例更低。在成年人中,人口统计学、社会经济和 CF 相关疾病协变量与达到总体护理水平和使用远程医疗都有显著关联。在儿科人群中,少数族裔和较低社会经济地位的标志物与较低的远程医疗使用率相关。在所有分析中,在 2019 年达到推荐的护理水平与报告的远程医疗使用以及在 2020 年达到 CF 护理模式的推荐要素的可能性更高相关。

结论

尽管广泛使用远程医疗,但 2020 年符合护理建议的参与者较少,并且远程医疗的使用并不等同于遵守 CF 护理的所有方面。

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