Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Ingham Institute of Applied Medical Research, Liverpool, Australia.
BMC Prim Care. 2024 Sep 4;25(1):325. doi: 10.1186/s12875-024-02570-7.
Group allied health interventions for people with chronic conditions may be a solution to increasing access to allied health in primary care. This umbrella review aimed to determine the effectiveness of allied health group interventions to improve health-related outcomes for adults with chronic conditions and the applicability of the findings to the Australian primary health care context.
An umbrella review of systematic reviews conducted April-July 2022, searching eight databases. Systematic reviews were eligible if they included randomised controlled trials (RCT) or quasi-RCTs, community dwelling adults aged ≥ 18, at least one chronic condition, group intervention in scope for allied health professionals, and published in English after 2000. Studies were excluded if interventions were conducted in hospital or aged care facilities, out of scope for allied health, or unsupervised.
Two thousand three hundred eighty-five systematic reviews were identified: after screening and full text review 154 were included and data extracted from 90. The chronic conditions included: cancer (n = 15), cardiovascular disease (n = 6), mixed chronic conditions (n = 3), kidney disease (n = 1), low back pain (n = 12), respiratory disease (n = 8), diabetes (n = 14), heart failure (n = 9), risk of falls (n = 5), hypertension (n = 4, osteoarthritis (n = 6) and stroke (n = 8). Most group interventions included prescribed exercise and were in scope for physiotherapists and exercise physiologists. Overall, allied health group exercise programs for community dwelling adults improved health outcomes for most chronic conditions. Aggregated data from the systematic reviews suggests programs of 45-60 min per session, 2-3 times per week for 12 weeks. Lifestyle education and support for people with type-2 diabetes improved glycaemic control.
Prescribed group exercise delivered by allied health professionals, predominantly by exercise physiologists and physiotherapists, significantly improved health outcomes for community dwelling adults with a broad range of chronic conditions.
为慢性病患者提供团体联合健康干预可能是增加初级保健中联合健康服务可及性的一种解决方案。本综述旨在确定联合健康团体干预对改善慢性病成人健康相关结局的有效性，并评估研究结果对澳大利亚初级保健背景的适用性。
2022 年 4 月至 7 月进行了一项系统综述的伞状综述，检索了 8 个数据库。如果系统综述包括随机对照试验（RCT）或准 RCT、社区居住的年龄≥18 岁的成年人、至少有一种慢性病、联合健康专业人员范围内的团体干预以及 2000 年后以英文发表，则符合纳入标准。如果干预措施在医院或老年护理机构进行、不属于联合健康范围或无人监督，则排除研究。
共确定了 2385 项系统综述：经过筛选和全文审查，纳入了 154 项，并从 90 项中提取数据。所涉及的慢性病包括：癌症（n=15）、心血管疾病（n=6）、混合慢性病（n=3）、肾脏疾病（n=1）、下腰痛（n=12）、呼吸疾病（n=8）、糖尿病（n=14）、心力衰竭（n=9）、跌倒风险（n=5）、高血压（n=4）、骨关节炎（n=6）和中风（n=8）。大多数团体干预措施包括规定的运动，且属于物理治疗师和运动生理学家的范围。总体而言，针对社区居住成年人的联合健康团体运动计划改善了大多数慢性病的健康结局。系统综述的汇总数据表明，每次 45-60 分钟、每周 2-3 次、持续 12 周的方案效果最佳。针对 2 型糖尿病患者的生活方式教育和支持改善了血糖控制。
由联合健康专业人员（主要是运动生理学家和物理治疗师）提供的规定团体运动显著改善了广泛慢性疾病社区居住成年人的健康结局。
