Billault B, Degoulet P, Devries C, Plouin P F, Chatellier G, Menard J
Medical Informatics Department, Hôpital Broussais, Paris.
MD Comput. 1995 Jan-Feb;12(1):31-5.
It is widely believed that patients' compliance can be increased by persuading them to participate in their own care. We tested whether patients with hypertension could manage their own clinical records and whether their doing so would affect the quality of their care. Two hundred patients were randomly assigned to an intervention or a control group. Those in the intervention group were asked to complete a 10-page booklet containing a personal standardized medical record. All patients were scheduled for a follow-up appointment at the end of one year and were referred to their general practitioners for interim care. At the end of the follow-up period, the proportion of patients seen was comparable in the two groups. More of the patients in the intervention group than in the control group filled out a questionnaire as requested, and more added comments. Within the intervention group, the proportion of patients seen and the fall in systolic blood pressure were significantly higher among the 44 patients who had completed the personal record as requested than among the 57 who had not. Patients who completed the personal record also had fewer compliance problems.
人们普遍认为，通过劝说患者参与自身护理可以提高他们的依从性。我们测试了高血压患者是否能够管理自己的临床记录，以及他们这样做是否会影响护理质量。200名患者被随机分为干预组或对照组。干预组的患者被要求填写一本包含个人标准化病历的10页手册。所有患者都安排在一年结束时进行随访预约，并被转介给他们的全科医生进行临时护理。在随访期结束时，两组中接受检查的患者比例相当。干预组中按照要求填写问卷的患者比对照组更多，添加评论的患者也更多。在干预组中，按照要求完成个人记录的44名患者中接受检查的患者比例和收缩压下降幅度显著高于未完成记录的57名患者。完成个人记录的患者依从性问题也更少。
