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数字化创新通过跨专业护理团队提高服务不足的高血压患者的护理质量(DIG IT)。

Digital Innovation to Grow Quality Care Through an Interprofessional Care Team (DIG IT) Among Underserved Patients With Hypertension.

机构信息

School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, Irvine, California

University of California Irvine Health Family Health Center, Irvine, California.

出版信息

Ann Fam Med. 2024 Sep-Oct;22(5):410-416. doi: 10.1370/afm.3151.

Abstract

PURPOSE

The impact of digital health on medically underserved patients is unclear. This study aimed to determine the early impact of a digital innovation to grow quality care through an interprofessional care team (DIG IT) on the blood pressure (BP) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score of medically underserved patients.

METHODS

This was a 3-month, prospective intervention study that included patients aged 40 years or more with BP of 140/90 mmHg or higher who received care from DIG IT from August through December 2021. Sociodemographic and clinical outcomes of DIG IT were compared with historical controls (controls) whose data were randomly extracted by the University of California Data Warehouse and matched 1:1 based on age, ethnicity, and baseline BP of the DIG IT arm. Multiple linear regression was performed to adjust for potential confounding factors.

RESULTS

A total of 140 patients (70 DIG IT, 70 controls) were included. Both arms were similar with an average age (SD) of 62.8 (9.7) years. The population was dominated by Latinx (79.3%) persons, with baseline mean BP of 163/81 mmHg, and mean ASCVD risk score of 23.9%. The mean (SD) reduction in systolic BP at 3 months in the DIG IT arm was twice that of the controls (30.8 [17.3] mmHg vs 15.2 [21.2] mmHg; <.001). The mean (SD) ASCVD risk score reduction in the DIG IT arm was also twice that of the controls (6.4% [7.4%] vs 3.1% [5.1%]; = .003).

CONCLUSIONS

The DIG IT was more effective than controls (receiving usual care). Twofold improvement in the BP readings and ASCVD scores in medically underserved patients were achieved with DIG IT.

摘要

目的

数字健康对医疗服务不足患者的影响尚不清楚。本研究旨在确定通过跨专业护理团队(DIG IT)的数字创新来提高护理质量对医疗服务不足患者的血压(BP)和 10 年动脉粥样硬化性心血管疾病(ASCVD)风险评分的早期影响。

方法

这是一项为期 3 个月的前瞻性干预研究,纳入了 2021 年 8 月至 12 月期间接受 DIG IT 护理且年龄在 40 岁及以上、BP 为 140/90mmHg 或更高的患者。DIG IT 的社会人口统计学和临床结果与通过加利福尼亚大学数据仓库随机提取数据的历史对照(对照组)进行了比较,并根据 DIG IT 臂的年龄、种族和基线 BP 进行了 1:1 匹配。采用多元线性回归来调整潜在的混杂因素。

结果

共纳入 140 例患者(70 例 DIG IT,70 例对照组)。两组在平均年龄(SD)为 62.8(9.7)岁方面相似。该人群主要为拉丁裔(79.3%),基线平均 BP 为 163/81mmHg,平均 ASCVD 风险评分 23.9%。DIG IT 组 3 个月时收缩压的平均(SD)降低幅度是对照组的两倍(30.8[17.3]mmHg 比 15.2[21.2]mmHg;<.001)。DIG IT 组 ASCVD 风险评分的平均(SD)降低幅度也是对照组的两倍(6.4%[7.4%]比 3.1%[5.1%];<.001)。

结论

DIG IT 比对照组(接受常规护理)更有效。DIG IT 使医疗服务不足患者的 BP 读数和 ASCVD 评分提高了两倍。

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Utilizing Digital Health Technologies for Patient Education in Lifestyle Medicine.利用数字健康技术进行生活方式医学中的患者教育。
Am J Lifestyle Med. 2019 Dec 13;14(2):137-142. doi: 10.1177/1559827619892547. eCollection 2020 Mar-Apr.

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