Evaluation of application effects of electronic clinical pathways for type 2 diabetes mellitus in community
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摘要: 目的 探索2型糖尿病电子临床路径的实证效果,为其在社区的进一步推广使用提供依据。 方法 选取2010年起与潍坊社区卫生服务中心全科医生进行家庭医生进行签约的糖尿病患者,从2016年6月—2017年5月入组其中264例为研究对象,采用随机数字方法随机分为电子临床路径组(132例)和对照组(132例),1年后对2组患者干预前后的体征、代谢指标进行比较。 结果 经过1年的电子临床路径规范化管理后,电子临床路径组的空腹血糖[(6.29±0.76)mmol/L]、糖化血红蛋白[(6.76±0.36)%]、低密度脂蛋白[(2.65±0.88) mmol/L]低于干预前[(7.80±0.65)mmol/L、(7.72±0.41)%、(2.81±0.93) mmol/L],差异均有统计学意义(均P<0.05);干预后,对照组的空腹血糖[(7.40±0.52)mmol/L]、糖化血红蛋白[(7.29±0.49)%]、低密度脂蛋白[(3.07±0.80) mmol/L],均高于电子临床路径组,差异均有统计学意义(均P<0.05)。 结论 电子临床路径不仅能够规范化全科医生的诊疗,强化对糖尿病患者的随访管理,还能提高患者的依从性和满意度。可考虑全面应用电子临床路径管理2型糖尿病患者,并向其他社区进行推广。Abstract: Objective To explore the empirical effect of electronic clinical pathway for type 2 diabetes mellitus, and to provide basis for its further promotion and use in the community. Methods A total of 264 patients with type 2 diabetes mellitus who have signed a family doctor contract with our general practitioners in Weifang Community Health Service Center from March to May 2010 were selected as study subjects. They were randomly divided into electronic clinical pathway group(132 cases) and control group(132 cases) by random number method. One year later, signs and metabolic indexes of the patients before and after intervention were compared. Results After 1 year of standardized management of electronic clinical pathway, fasting blood glucose [(6.29±0.76) mmol/L], HbA1 c [(6.76± 0.36)%], and low-density lipoprotein [(2.65±0.88) mmol/L] in the electronic clinical pathway group were lower than that before intervention [(7.80± 0.65) mmol/L,(7.72±0.41) %, and(2.81±0.93) mmol/L, respectively], with statistically significant differences(all P<0.05). After intervention, fasting blood glucose [(7.40±0.52) mmol/L], HbA1 c [(7.29±0.49)%], and low-density lipoprotein [(3.07±0.80) mmol/L] in the electronic clinical pathway group were all lower than those in the control group, with statistically significant differences(all P<0.05). Conclusion Electronic clinical pathway can not only standardize the diagnosis and treatment of general practitioners, strengthen the follow-up management of patients with diabetes, but also improve the compliance and satisfaction of patients. Comprehensive use of electronic clinical pathways for the management of type 2 diabetes mellitus could be considered and extended to other communities.
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Key words:
- Type 2 diabetes mellitus /
- Electronic clinical pathway /
- Effect evaluation
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