Use of IndiGO individualized clinical guidelines in primary care
Use of IndiGO individualized clinical guidelines in primary care
复制标题
DOI：
10.1136/amiajnl-2012-001595
复制
发表时间：
2014-05-01
影响因子：
6.4
通讯作者：
Young, Scott S.
中科院分区：
文献类型：
--
作者：
Bellows, Jim;Patel, Samir;Young, Scott S.
目的探讨IndiGO个性化临床指南在临床实践中的应用，评价其对护理效果和护理体验的影响。方法采用配对比较观察设计。基于生物数学模拟模型的IndiGO个性化指南用于共享决策。医生和患者在动态用户界面上查看风险评估和量身定制的建议，并讨论5-10分钟。结果测量是靛蓝推荐药物的处方和配药，生理指标的变化和预测的5年心脏病发作和中风风险，以及医生和患者的认知。结果使用IndiGO的489例患者接受他汀类药物处方的可能性是常规护理对照组的4.9倍（p=0.015）。对抗高血压药物的处方没有影响，但使用靛蓝的患者更有可能选择至少一种配药(p
Objective To determine if IndiGO individualized clinical guidelines could be implemented in routine practice and assess their effects on care and care experience.Methods Matched comparison observational design. IndiGO individualized guidelines, based on a biomathematical simulation model, were used in shared decision-making. Physicians and patients viewed risk estimates and tailored recommendations in a dynamic user interface and discussed them for 5-10 min. Outcome measures were prescribing and dispensing of IndiGO-recommended medications, changes in physiological markers and predicted 5-year risk of heart attack and stroke, and physician and patient perceptions.Results 489 patients using IndiGO were 4.9 times more likely to receive a statin prescription than were matched usual care controls (p=0.015). No effect was observed on prescribing of antihypertensive medications, but IndiGO-using patients were more likely to pick up at least one dispensing (p