Galán Marisa, Sellarès Jaume, Monteserín Rosa, Vicuña Johanna, Moral Irene, Brotons Carlos
EAP Sardenya, Barcelona, España; Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària ACEBA, Barcelona, España; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, España.
EAP Sardenya, Barcelona, España; Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària ACEBA, Barcelona, España; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, España.
Aten Primaria. 2024 Jun;56(6):102853. doi: 10.1016/j.aprim.2023.102853. Epub 2024 Jan 19.
To evaluate the effectiveness of the incorporation of the clinical assistant in improving the control of type 2 diabetes mellitus and hypertension in a primary care center.
Quasi-experimental study (pre-post), with a control group, with a 1-year follow-up.
Primary care center.
Patients between the ages of 18 and 85 with a diagnosis of diabetes type 2 and/or hypertension were selected.
Incorporation of the figure of the clinical assistant, previously trained. The latter contacted the patient to explain their role and obtain informed consent, assessed compliance with the protocols, and when they were incomplete and/or detected warning signs, referred the patient directly to medicine and/or nursing.
Three thousand and sixty-four patients participated, 30.74% assigned to the intervention group. Fifty percent were women. The mean age was 68.5 years (SD 11.07). 93.59% of diabetic patients in the intervention group had at least one determination of glycosylated hemoglobin compared to 86.83% in the control group (p=0.003). Fundus and diabetic foot screening was significantly higher in the intervention group (94.31% and 85.41% vs. 83.49% and 72.38%). 88.43% of the patients in the intervention group had registered blood pressure figures compared to 62.06% of the patients in the control group (p<0.05). There were not statistically significant differences in the control of blood pressure between the patients with recorded measures (p=0.478).
Clinical assistants can facilitate the implementation and compliance with chronic diseases protocols, and in the long run improve the degree of control of these patients and the quality of care.
评估在初级保健中心引入临床助理对改善2型糖尿病和高血压控制效果的作用。
类实验性研究（前后对照），设有对照组，随访1年。
初级保健中心。
选取年龄在18至85岁之间、诊断为2型糖尿病和/或高血压的患者。
引入经过预先培训的临床助理角色。临床助理联系患者解释其职责并获得知情同意，评估方案依从性，当依从性不完全和/或发现警示信号时，直接将患者转诊至内科和/或护理部门。
3064名患者参与研究，30.74%被分配至干预组。50%为女性。平均年龄为68.5岁（标准差11.07）。干预组中93.59%的糖尿病患者至少进行了一次糖化血红蛋白测定，而对照组为86.83%（p = 0.003）。干预组的眼底和糖尿病足筛查率显著更高（分别为94.31%和85.41%，对照组为83.49%和72.38%）。干预组88.43%的患者记录了血压数值，而对照组为62.06%（p < 0.05）。在记录了血压测量值的患者中，血压控制方面无统计学显著差异（p = 0.478）。
临床助理可促进慢性病方案的实施和依从性，从长远来看可提高这些患者的控制程度和护理质量。
