Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic
Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic
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日本老年患者糖尿病护理的连续性：糖尿病专业诊所的病历审查研究
DOI：
10.1007/s13340-022-00569-y
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发表时间：
2022
影响因子：
2.2
通讯作者：
Kawai Koichi
中科院分区：
文献类型：
--
作者：
Tanaka Rie;Motohashi Shinobu;Morioka Junko;Takahashi Akimitsu;Yamazaki Katsuya;Kawai Koichi
糖尿病护理的连续性在老年患者中是相关的。本研究的目的是调查临床特征的影响，继续门诊访问一个专门的糖尿病门诊在老年日本patients with diabetes.MethodsWe包括门诊2型糖尿病患者年龄≥ 65岁谁第一次访问我们的诊所从2006年至2009年。通过CoDiC数据库中的病历审查获得患者特征信息。我们跟踪了患者是否继续到诊所就诊，直到2019年5月31日。A考克斯比例风险回归模型确定变量相关withdrawt.ResultsAmong 128例患者，63例（49.2%）在随访期间退出。退出研究的平均访视持续时间为4.6年（范围：1 - 10年）。与继续访视的患者相比，停止访视的患者年龄较大（72.6岁vs. 69.5岁，p= 0.005）。各组首次访视与末次访视之间的糖尿病并发症、Charlson Comorbid指数和多种药物治疗等临床状况无显著差异。年龄（≥ 75岁）与退出显著相关（风险比2.72 [95%置信区间1.59，4.63]，p< 0.001）。除年龄外，在所有变量中均未观察到显著差异，当调整混杂因素时，ConclusionsOur研究结果表明，日本老年糖尿病患者难以连续门诊就诊。年龄较大（≥ 75岁）独立影响退出。未来的多中心研究，有足够的人口和社会和老年因素是必要的，以证实我们的研究结果。
AimsContinuity of diabetes care is relevant among elderly patients. The aim of this study is to investigate the impact of clinical characteristics on continuing outpatient visits to a specialized diabetes clinic in elderly Japanese patients with diabetes.MethodsWe included outpatients with type 2 diabetes aged ≥ 65 years who first visited our clinic from 2006 to 2009. The information of patients’ characteristics was obtained through medical record review from the CoDiC database. We have tracked whether the patients continued to visit the clinic until May 31, 2019. A Cox proportional hazards regression model identified variables related to withdrawal.ResultsAmong 128 patients, 63 patients (49.2%) were withdrawn during the follow-up periods. The average visit duration of withdrawals was 4.6 (range 1, 10) years. The patients who discontinued to visit were older (72.6 vs. 69.5 years old,p= 0.005) compared with those who continued to visit. No significant differences in clinical conditions such as complication of diabetes, Charlson Comorbidity Index and polypharmacy between the first and last visit were observed in each group. Age (≥ 75 years) was significantly associated with withdrawal (hazard ratio 2.72 [95% confidence interval 1.59, 4.63],p< 0.001). Except for age, no significant differences were observed in all variables when adjusted for confounders.ConclusionsOur findings indicated that continuous outpatient visits were difficult in elderly Japanese patients with diabetes. Older age (≥ 75 years) independently affected withdrawal. Future multicenter studies with adequate populations and social and geriatric factors are necessary to confirm our findings.