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中国社区老年房颤患者对房颤更佳照护(ABC)路径管理的依从性:一项横断面研究

Adherence to Atrial Fibrillation Better Care (ABC) Pathway Management of Chinese Community Elderly Patients with Atrial Fibrillation: A Cross-Sectional Study.

作者信息

Zhang Xiaomin, Huang Jun, Weng Fan, Wen Yanting, Wang Xiaoxia, Jiang Junrong, Xue Yumei, Li Kun

机构信息

School of Nursing, Sun Yat-Sen University, Guangzhou, People's Republic of China.

Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China.

出版信息

Patient Prefer Adherence. 2023 Jul 25;17:1813-1823. doi: 10.2147/PPA.S417384. eCollection 2023.

Abstract

BACKGROUND

Investigating adherence to the Atrial Fibrillation Better Care (ABC) pathway management and identifying gaps between the real world and established guidelines can lead to better integrated management of AF. Current data on adherence to ABC pathway management among community elderly patients with atrial fibrillation (AF) in Chinese communities is limited.

AIM

To investigate the adherence to ABC pathway management among community elderly patients with AF in China.

METHODS

In this cross-sectional study, data were collected from the 2020 National Basic Public Health Service Program database that includes health examination information for all residents >65 years of age in Yuexiu, Guangzhou, Guangdong Province. Demographic and clinical characteristics data from 197 community AF patients were obtained.

RESULTS

Among the 197 AF patients, 103 (52.3%) were male, 117 (59.4%) were ≥75 years of age, 127 (64.5%) had a senior middle school education or above, 84.3% were married, and 195 (99.0%) had medical insurance. The most common comorbidities were hypertension (72.1%, 142/197), dyslipidaemia (28.4%, 56/197), CAD (28.9%, 57/197), and diabetes (24.9%, 49/197). In terms of the ABC management pathway, 21.8% (43/197), 82.7% (163/197), and 31.5% (62/197) of AF patients were classified into the A-adherent group, B-adherent group, and C-adherent group, respectively. The level of adherence to ABC pathway management was very low (9.1%, 18/197) and independently associated with age and multimorbidity.

CONCLUSION

The level of adherence to ABC pathway management in community elderly patients with AF was unsatisfactory. Further research is warranted to improve the integrated management of AF.

摘要

背景

研究心房颤动更佳照护(ABC)路径管理的依从性,并找出现实情况与既定指南之间的差距,有助于实现更好的心房颤动综合管理。目前关于中国社区老年心房颤动(AF)患者对ABC路径管理依从性的数据有限。

目的

调查中国社区老年AF患者对ABC路径管理的依从性。

方法

在这项横断面研究中,数据收集自2020年国家基本公共卫生服务项目数据库,该数据库包含广东省广州市越秀区所有65岁以上居民的健康检查信息。获取了197例社区AF患者的人口统计学和临床特征数据。

结果

在197例AF患者中,男性103例(52.3%),年龄≥75岁者117例(59.4%),高中及以上学历者127例(64.5%),已婚者占84.3%,有医疗保险者195例(99.0%)。最常见的合并症为高血压(72.1%,142/197)、血脂异常(28.4%,56/197)、冠心病(28.9%,57/197)和糖尿病(24.9%,49/197)。在ABC管理路径方面,分别有21.8%(43/197)、82.7%(163/197)和31.5%(62/197)的AF患者被归类为A依从组、B依从组和C依从组。ABC路径管理的依从水平非常低(9.1%,18/197),且与年龄和多种合并症独立相关。

结论

社区老年AF患者对ABC路径管理的依从水平不尽人意。有必要进一步开展研究以改善AF的综合管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cd4/10386861/b3347bc1ed0d/PPA-17-1813-g0001.jpg

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