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数字疾病管理项目减少了在种族和社会弱势群体中存在的慢性胃肠道症状。

Digital disease management programme reduces chronic gastrointestinal symptoms among racially and socially vulnerable populations.

机构信息

Cylinder, Chicago, Illinois, USA.

Cylinder, Chicago, Illinois, USA

出版信息

BMJ Open Gastroenterol. 2024 Aug 28;11(1):e001463. doi: 10.1136/bmjgast-2024-001463.

Abstract

OBJECTIVE

Considerable disparities exist in access to gastrointestinal (GI) care and digestive outcomes across gender, racial, and socioeconomic groups. We evaluated (1) whether adults with chronic GI symptoms from diverse demographic groups would use a digital digestive care programme and (2) the effects of participation on GI symptom severity and other patient-reported outcomes.

METHODS

Access to a digital digestive chronic care programme was provided to participants regardless of prior digestive diagnoses or symptoms for 90 days. The intervention included GI symptom tracking, personalised medical nutrition therapy, GI-specific health coaching, and targeted education on common GI symptoms. We assigned a Social Vulnerability Index (SVI) score to each participant according to their home address and compared baseline and end-intervention symptoms and other patient-reported outcomes by gender, race/ethnicity, and SVI.

RESULTS

Of the 1936 participants, mean age was 43.1 years; 67% identified as white/Caucasian, 11% Asian/Pacific Islander, 6% Hispanic/Latinx, 7% black/African American, and 7% of multiple races. Participants of all demographic groups used the app symptom logging, reviewed educational materials, and interacted with their care team and reported similar statistically significant improvements in GI symptoms (by the end of the intervention, 85% improved, p<0.05). Participants reported feeling greater control of their health (83%), better able to manage their digestive symptoms (83%), increased happiness (76%), and greater productivity at work (54%), with black/African Americans and Native Americans most likely to report these changes.

CONCLUSION

We conclude that a digital GI disease management programme may be of value in reducing disparities in access to GI care.

摘要

目的

在获得胃肠道(GI)护理和消化结果方面,存在着相当大的性别、种族和社会经济群体之间的差异。我们评估了(1)来自不同人口统计学群体的慢性 GI 症状的成年人是否会使用数字消化护理计划,以及(2)参与对 GI 症状严重程度和其他患者报告结果的影响。

方法

无论先前是否有消化诊断或症状,参与者都可以在 90 天内获得数字消化慢性护理计划的访问权限。该干预措施包括 GI 症状跟踪、个性化医学营养治疗、GI 特定健康指导以及针对常见 GI 症状的针对性教育。我们根据参与者的家庭住址为每个参与者分配了一个社会脆弱性指数(SVI)评分,并按性别、种族/族裔和 SVI 比较了基线和干预结束时的症状和其他患者报告的结果。

结果

在 1936 名参与者中,平均年龄为 43.1 岁;67%的人自认为是白人/高加索人,11%的人是亚裔/太平洋岛民,6%的人是西班牙裔/拉丁裔,7%的人是黑人/非裔美国人,7%的人是多种族裔。所有人口统计学群体的参与者都使用了应用程序症状记录、查看教育材料并与他们的护理团队互动,并报告了类似的 GI 症状显著改善(在干预结束时,85%的人改善,p<0.05)。参与者表示对自己的健康有了更大的控制感(83%),能够更好地管理他们的消化症状(83%),增加了幸福感(76%),工作效率提高(54%),黑人/非裔美国人和美国原住民最有可能报告这些变化。

结论

我们的结论是,数字 GI 疾病管理计划可能有助于减少 GI 护理获取方面的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6036/11367377/13920bbcebbe/bmjgast-11-1-g001.jpg

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