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加强慢性病管理:来自农村和城市全科医生实践的个性化医疗见解。

Enhancing Chronic Disease Management: Personalized Medicine Insights from Rural and Urban General Practitioner Practices.

作者信息

Duda-Sikuła Marta, Kurpas Donata

机构信息

Clinical Trial Support Centre, Wroclaw Medical University, 50-367 Wrocław, Poland.

Department of Family and Pediatric Nursing, Faculty of Health Sciences, Wroclaw Medical University, 50-996 Wrocław, Poland.

出版信息

J Pers Med. 2024 Jul 1;14(7):706. doi: 10.3390/jpm14070706.

Abstract

Health policies worldwide emphasize managing chronic conditions like diabetes and hypertension through medication and lifestyle modifications. However, translating guidelines into practical application remains challenging, leading to suboptimal care and poor health outcomes, particularly in low-resource settings. This study aims to reveal significant differences between rural and urban patients requiring personalized approaches to chronic disease management based on geographical location and demographic data, considering the impact of emergencies such as the COVID-19 pandemic. Data were collected from rural and urban general practitioner (GP) practices in Poland, covering four years from 2018 to the first quarter of 2021, focusing on diabetes and hypertension epidemiology, risk factors, comorbidities, resource consumption, and disease burden. The findings revealed significant differences between rural and urban patients regarding age, number of patient visits, gender distribution, and types of diagnoses and visit modalities. Rural patients tended to be older, had a higher median number of visits, and exhibited different patterns of diagnoses and visit types compared to urban patients. The study also investigated the impact of the COVID-19 pandemic on chronic disease treatment, finding that while age at visits increased during the pandemic, there were no significant changes in gender distribution, but a noticeable shift in diagnoses and visit modalities with an increase in remote visits and changes in the prevalence of specific diagnoses. These disparities highlight the need for tailored approaches to chronic disease management based on geographic location and patient demographics. The study underscores the importance of understanding the unique challenges and opportunities in managing chronic diseases across different settings and during public health crises like the COVID-19 pandemic, aiding healthcare providers and policymakers in developing targeted interventions to improve chronic disease prevention and management, ultimately leading to better health outcomes for individuals and communities. Further research is needed to explore the long-term effects of the pandemic on chronic disease treatment and assess the effectiveness of interventions to mitigate its impact.

摘要

全球卫生政策强调通过药物治疗和生活方式改变来管理糖尿病和高血压等慢性病。然而,将指南转化为实际应用仍然具有挑战性,导致医疗服务效果欠佳和健康状况不佳,尤其是在资源匮乏地区。本研究旨在揭示农村和城市患者之间的显著差异,考虑到新冠疫情等紧急情况的影响,需要根据地理位置和人口数据对慢性病管理采取个性化方法。数据收集自波兰农村和城市的全科医生诊所,涵盖2018年至2021年第一季度的四年时间,重点关注糖尿病和高血压的流行病学、风险因素、合并症、资源消耗和疾病负担。研究结果显示,农村和城市患者在年龄、就诊次数、性别分布以及诊断类型和就诊方式方面存在显著差异。农村患者往往年龄较大,就诊次数中位数较高,与城市患者相比,诊断模式和就诊类型也有所不同。该研究还调查了新冠疫情对慢性病治疗的影响,发现疫情期间就诊年龄有所增加,性别分布没有显著变化,但诊断和就诊方式有明显转变,远程就诊增加,特定诊断的患病率也有所变化。这些差异凸显了根据地理位置和患者人口统计学特征采取针对性慢性病管理方法的必要性。该研究强调了了解不同环境下以及在新冠疫情等公共卫生危机期间管理慢性病的独特挑战和机遇的重要性,有助于医疗服务提供者和政策制定者制定有针对性的干预措施,以改善慢性病的预防和管理,最终为个人和社区带来更好的健康结果。需要进一步研究以探索疫情对慢性病治疗的长期影响,并评估减轻其影响的干预措施的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7671/11277769/b5d01193df2b/jpm-14-00706-g001.jpg

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