Introduction of diabetes passport involving both patients and professionals to improve hospital outpatient diabetes care
Introduction of diabetes passport involving both patients and professionals to improve hospital outpatient diabetes care
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DOI：
10.1016/j.diabres.2004.09.020
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发表时间：
2005-05-01
影响因子：
5.1
通讯作者：
Grol, RPTM
中科院分区：
文献类型：
--
作者：
Dijkstra, RF;Braspenning, JCC;Grol, RPTM
目的：为了调查是否涉及患者和专业人士的综合战略，引入糖尿病护照作为一个关键组成部分，提高糖尿病care.Methods：第一个150连续患者谁访问了他们的内科医生的糖尿病检查在内科门诊部在9个荷兰综合医院，包括在这1年的集群，随机，对照试验。卫生保健专业人员参加了一个关于糖尿病护照使用和传播的教育会议，这是一个病人持有的记录。他们还收到了关于基线数据和个人反馈的汇总反馈。还为患者组织了教育会议。患者档案与问卷调查一起使用，以确定依从率。结果：HbA 1 c水平变化虽小，但有显著性意义。在干预组中，与对照组（+0.2%）相比，患者的健康状况发生了积极变化（-0.3%）。舒张压略有改善，但收缩压或胆固醇没有变化。结果发现，在患者足部检查水平和患者教育水平方面有所改善。结论：努力改善专业人员和患者的专业实践，可使HbA（1）c和舒张压水平略有改善。需要进一步研究，以确定是否有一个更好的结构化的医疗保健服务，在一个更支持的环境中运作，可以提高这些效果。(c)2004爱思唯尔爱尔兰有限公司保留所有权利。
Aim: To investigate whether a comprehensive strategy involving both patients and professionals, with the introduction of a diabetes passport as a key component, improves diabetes care.Methods: The first 150 consecutive patients who visited their internist for a diabetes check up at the internal medicine outpatient departments at each of nine Dutch general hospitals were included in this 1 year clustered, randomised, controlled trial. Health care professionals attended an educational meeting about the use and dissemination of the diabetes passport which is a patient held record. They also received aggregated feedback on baseline data and personal feedback. Educational meetings were also organised for patients. Patient files were used in conjunction with questionnaires to determine adherence rates. Data were analysed using multilevel regression analysis.Results: Small but significant changes were found in mean HbA(1)c levels. In the intervention group, positive health changes for patients were found (-0.3%) when compared to those in the control group (+0.2%). Diastolic blood pressure improved slightly, but no changes were found in systolic blood pressure or cholesterol. Improvements were found with regard to levels of examination of patients' feet and in patient education.Conclusions: Efforts to improve professional practice involving both professionals and patients led to small improvements in HbA(1)c and diastolic blood pressure levels. Further study is needed to establish whether a better structured health care delivery, operating in a more supportive environment can enhance these effects. (c) 2004 Elsevier Ireland Ltd. All rights reserved.