The evaluation of routine hypertension therapy based contract service on the long-term prescription in Shanghai
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摘要: 目的 研究和评价上海市慢性病长处方签约服务工作的效果。 方法 随机选取2016年9月—2018年2月期间在上海市徐汇区某社区站点已纳入慢性病长处方签约服务的高血压患者100例,作为长处方组;未纳入慢性病长处方签约服务的高血压患者100例,作为非长处方组。长处方组:在家庭医生签约的基础上签约慢性病长处方服务,每次复诊开具2个月(8周)的药品用量。非长处方组:每次复诊开具1个月(4周)的药品用量。研究时间为6个月,所有研究对象进行期初和期末检测和评价,取得数据资料后进行对照分析。 结果 比较长处方组研究对象6个月前后的收缩压和舒张压情况,差异无统计学意义(均P>0.05),服药依从性、服务满意度、6个月内就医次数、6个月内就医时间、6个月内就医费用方面的差异均有统计学意义(均P<0.05)。比较长处方组和非长处方组研究对象6个月前后观测指净变化值,收缩压和舒张压差异无统计学意义(均P>0.05),认知性症状管理、症状管理自我效能、与医生交流、健康自评、健康担忧、疾病对生活的影响、6个月看病次数、服药依从性、服务满意度、6个月内就医时间、6个月内就医费用方面的差异均有统计学意义(均P<0.05)。 结论 基于社区高血压病诊疗实践,上海市慢性病长处方签约服务工作在一定范围内取得良好效果,可以此为鉴,推广实施,并为慢性病分级诊疗政策的制定和其他慢性病病种长处方工作的开展提供依据。Abstract: Objective To evaluate the effect of routine hypertension therapy based contract service on the long-term prescription in Shanghai. Methods Two hundreds subjects were selected according to the inclusive criteria from September 2016 to February 2018, and were randomly assigned to long prescription group and non-long prescription group. The subjects in long prescription group signed the chronic disease long-term description service, and received the drugs for 8 weeks every visiting time. While the subjects in non-long prescription group only received drugs for 4 weeks. The study lasted 6 months. All subjects were tested and evaluated both at the beginning and end of the term. Results In the long prescription group, there were no significant differences insystolic and diastolic blood pressure before and after treatment (all P>0.05); there were significant differences in medication compliance, service satisfaction, patient visits, the time of medical treatment and the cost of medical treatment within 6 months. The net change values between the two groups were not significant in both systolic and diastolic blood pressure (all P>0.05); there were significant difference in cognitive symptom management, symptom management self-efficacy, communication with doctors, health self-assessment, health concerns, the impact of disease on life, medication compliance, service satisfaction, medical visits, the time and cost of medical treatment within 6 months (all P<0.05). Conclusion Our results showed that the effects of routine hypertension therapy based contract service on the long-term prescription were promising in our community. The long prescription model can be borrowed to manage other chronic diseases community health service centers.
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Key words:
- Chronic diseases /
- Long-term prescription /
- Hypertension /
- Family doctor signing service
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