Hamasaki Hidetaka
Japan Medical Exercise Association, 4-29-16 Tsukushino, Machida, Tokyo 194-0001, Japan.
Healthcare (Basel). 2024 Dec 13;12(24):2530. doi: 10.3390/healthcare12242530.
Patient experience is a critical healthcare quality indicator, evolving from Patient Satisfaction (PS) and encompassing patients' concrete healthcare experiences. It is increasingly vital in aging societies where collaborative efforts among patients, families, and healthcare professionals are essential. Studies suggest that enhanced patient experience leads to better adherence, outcomes, and patient safety. This paper reviews patient experience evaluations in older adults with diabetes through randomized controlled trial (RCT)-based findings. The author searched PubMed/MEDLINE, Embase, AMED, and CINAHL. The review focused on RCTs examining interventions affecting patient experience and PS in T2D/T1D patients aged ≥65. A total of 13 RCTs were eligible for this review. This review highlights studies on diabetes management in older adults, assessing the impact of health education, diabetes management programs, treatments, mHealth, and advanced insulin delivery systems. Early studies showed that education improved self-care but had a limited impact on glycemic control. Key findings include the effectiveness of experience-based education in improving HbA1c, the benefits of insulin therapy for elderly patients, and the value of structured peer-to-peer diabetes management programs in enhancing satisfaction. Patient adherence, satisfaction, and personalized support emerged as critical factors influencing diabetes management across various interventions. More recent trials involving mHealth demonstrated improvements in glycemic control and PS through automated data sharing and app-based support. Closed-loop insulin delivery studies reported reduced mental strain, improved glycemic control, and better quality of life, despite barriers such as device cost and occasional system limitations. These interventions highlight the potential of advanced technologies to enhance diabetes care, particularly for aging populations. Previous RCTs show that education, structured management programs, effective insulin therapies, and advanced digital treatments improve patient experience, though well-designed studies focusing on patient experience as a primary outcome are lacking. Developing patient experience assessment scales for aging diabetes patients and adapting healthcare systems to maximize patient experience amid digitalization trends are essential, warranting further research.
患者体验是一项关键的医疗质量指标,它由患者满意度(PS)发展而来,涵盖了患者具体的医疗体验。在老龄化社会中,患者、家庭和医疗专业人员之间的协作至关重要,患者体验也变得越来越重要。研究表明,改善患者体验可带来更好的依从性、治疗效果和患者安全。本文通过基于随机对照试验(RCT)的研究结果,综述了老年糖尿病患者的患者体验评估。作者检索了PubMed/MEDLINE、Embase、AMED和CINAHL。该综述聚焦于考察影响≥65岁2型糖尿病/1型糖尿病患者的患者体验和PS的干预措施的RCT。共有13项RCT符合本综述的要求。本综述重点介绍了关于老年患者糖尿病管理的研究,评估了健康教育、糖尿病管理项目、治疗方法、移动健康和先进胰岛素输送系统的影响。早期研究表明,教育可改善自我护理,但对血糖控制的影响有限。主要研究结果包括基于体验的教育在改善糖化血红蛋白方面的有效性、胰岛素治疗对老年患者的益处,以及结构化的同伴糖尿病管理项目在提高满意度方面的价值。患者依从性、满意度和个性化支持是影响各种干预措施下糖尿病管理的关键因素。最近涉及移动健康的试验表明,通过自动数据共享和基于应用程序的支持,血糖控制和PS得到了改善。闭环胰岛素输送研究报告称,尽管存在设备成本和偶尔的系统限制等障碍,但精神压力有所减轻,血糖控制得到改善,生活质量也有所提高。这些干预措施凸显了先进技术在改善糖尿病护理方面的潜力,尤其是对老年人群体。先前的RCT表明,教育、结构化管理项目、有效的胰岛素治疗和先进的数字治疗可改善患者体验,不过缺乏将患者体验作为主要结局的精心设计的研究。为老年糖尿病患者开发患者体验评估量表,并使医疗系统适应数字化趋势以最大限度地提升患者体验至关重要,值得进一步研究。