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加拿大魁北克一所公立大学家庭医学组的多学科护理:患者随访及心脏代谢风险管理数据

Multidisciplinary Care in a Public University Family Medicine Group in Québec (Canada): Data on Patients' Follow-Up and Cardiometabolic Risk Management.

作者信息

Leblay Lise, Pelland Léanne Day, Gagnon Josée, Guay Valérie, Desroches Sophie, Drouin-Chartier Jean-Philippe, Paquette Jean-Sébastien

机构信息

Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.

Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada.

出版信息

Healthcare (Basel). 2025 Jul 15;13(14):1704. doi: 10.3390/healthcare13141704.

Abstract

Generating real-world data on the efficacy of multidisciplinary care in cardiometabolic risk management is essential to ensure that guidelines are both applicable and effective, especially in public healthcare settings, where organizational structures may impede healthcare professionals' agility. This study aimed to generate data on patient follow-up and cardiometabolic risk management during the early years of a public university family medicine group in Québec (Canada) that provides multidisciplinary care to adults with cardiometabolic conditions, in order to evaluate the implementation and effectiveness of its care model. This was a retrospective longitudinal study. Patients treated at the clinic from 31 January 2020 (clinic opening) to 8 May 2024 (n = 96) were invited to consent to the use of their medical data for research. A total of 52 patients consented and were included in the study. Upon entry at the clinic, >90% of patients had anthropometry and blood pressure (BP) measured, but plasma glucose and lipids were assessed among 50% and 79% of patients, respectively. A total of 36 patients completed the personalized multidisciplinary care program. No evidence of associations between the total number of appointments or appointments with the registered dietitian specifically with changes in BMI, waist circumference, and BP was found. However, each pharmaceutical intervention was associated with a -0.51 cm (95%CI: -1.03, 0.02; = 0.06) change in waist circumference and a -1.49 mm Hg (95%CI: -2.56, -0.43, = 0.01) change in diastolic BP. : These data highlight the challenges of implementing a research-oriented clinic within Québec's public healthcare system.

摘要

生成关于多学科护理在心脏代谢风险管理中疗效的真实世界数据,对于确保指南既适用又有效至关重要,尤其是在公共医疗环境中,因为组织结构可能会阻碍医疗专业人员的灵活性。本研究旨在生成加拿大魁北克一所公立大学家庭医学组在为患有心脏代谢疾病的成年人提供多学科护理的早期阶段,关于患者随访和心脏代谢风险管理的数据,以评估其护理模式的实施情况和有效性。这是一项回顾性纵向研究。邀请了2020年1月31日(诊所开业)至2024年5月8日在该诊所接受治疗的患者(n = 96)同意将其医疗数据用于研究。共有52名患者同意并被纳入研究。在进入诊所时,超过90%的患者进行了人体测量和血压测量,但分别有50%和79%的患者进行了血糖和血脂评估。共有36名患者完成了个性化多学科护理计划。未发现预约总数或与注册营养师的预约数与体重指数、腰围和血压变化之间存在关联的证据。然而,每次药物干预与腰围变化-0.51厘米(95%置信区间:-1.03,0.02;P = 0.06)和舒张压变化-1.49毫米汞柱(95%置信区间:-2.56,-0.43,P = 0.01)相关。这些数据凸显了在魁北克公共医疗系统内实施以研究为导向的诊所所面临的挑战。

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