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用于门诊预约分诊和排程的电子患者报告结局测量:一项系统评价和荟萃分析。

Electronic patient-reported outcome measures for triaging and scheduling outpatient appointments: a systematic review and meta-analysis.

作者信息

He Chen, Xia Yuelin, Cheung Ying Shan, Lam Sze Tung, Chen Suephy C, Valderas Jose M, Choi Ellie

机构信息

Department of Medicine, National University Hospital, Singapore 119074, Singapore.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.

出版信息

J Am Med Inform Assoc. 2025 Jul 1;32(7):1219-1226. doi: 10.1093/jamia/ocaf078.

Abstract

OBJECTIVES

This study aims to review the effectiveness of electronic patient-reported outcome measures (ePROMs) to triage and schedule appointments for adult patients with chronic medical conditions.

MATERIALS AND METHODS

A structured search was implemented in electronic databases for randomized controlled trials that compared use of ePROMs to facilitate flexible scheduling of appointments (intervention) with conventional scheduling practices (control) in adult outpatients with chronic medical condition. The primary outcome was the difference in healthcare utilization, measured by the number of outpatient physical appointments. Secondary outcomes include disease control and implementational outcomes. A meta-analysis using random effects modeling was performed.

RESULTS

The search strategy yielded 3769 citations and 1 additional article from hand search; 17 randomized controlled trials (6469 patients) were included. Most studies focused on cancer (n = 9) or rheumatoid arthritis (n = 3). Six out of 10 studies comparing the number of physical appointments showed that ePROMs significantly reduced the mean number of physical appointments, while 1 study reported increased appointments. A meta-analysis of 6 studies with sufficient data for pooling indicated that the ePROMs group had fewer appointments, with a mean difference of -1.12 (CI, -1.87 to -0.37). Among 10 studies evaluating disease control, 2 showed improved disease control with ePROMs, 2 reported improved survival in cancer patients, while 6 found no significant differences.

DISCUSSION

Current evidence supports the feasibility and acceptability of incorporating ePROMs in outpatient visit scheduling, with a reduction in physical appointments without compromising disease outcomes.

CONCLUSION

ePROMs can be used to support and guide decisions regarding outpatient appointment scheduling.

摘要

目的

本研究旨在评估电子患者报告结局指标(ePROMs)在为患有慢性疾病的成年患者进行分诊和安排预约方面的有效性。

材料与方法

在电子数据库中进行结构化检索,以查找随机对照试验,这些试验比较了在患有慢性疾病的成年门诊患者中,使用ePROMs促进灵活预约安排(干预)与传统预约做法(对照)的情况。主要结局是医疗保健利用率的差异,通过门诊体格检查预约次数来衡量。次要结局包括疾病控制和实施结局。采用随机效应模型进行荟萃分析。

结果

检索策略产生了3769条引文,手工检索又获得1篇文章;纳入了17项随机对照试验(6469名患者)。大多数研究聚焦于癌症(n = 9)或类风湿关节炎(n = 3)。在比较体格检查预约次数的10项研究中,有6项表明ePROMs显著减少了体格检查预约的平均次数,而1项研究报告预约次数增加。对6项有足够数据进行汇总的研究进行的荟萃分析表明,ePROMs组的预约次数更少,平均差异为-1.12(CI,-1.87至-0.37)。在评估疾病控制的10项研究中,2项显示ePROMs改善了疾病控制,2项报告癌症患者生存率提高,而6项未发现显著差异。

讨论

目前的证据支持将ePROMs纳入门诊就诊安排的可行性和可接受性,在不影响疾病结局的情况下减少了体格检查预约次数。

结论

ePROMs可用于支持和指导有关门诊预约安排的决策。

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