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Chronic disease management is seen as a breakthrough point for establishing the hierarchical medical system, also an important task in building a healthy China. We summarized the experiences of the chronic diseases management of Beijing Chao-Yang Hospital, focusing on the establishment of a chronic diseases management team, development of the diagnosis and treatment norms and management procedures, and the interoperable information platform. And we introduced the practical effects, such as guiding patients to primary medical institutions, reducing medical costs, and improving the primary capabilities to manage chronic diseases, and existing problems of the management model.
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Objective To evaluate the effectiveness of general practitioner contracted service in management of patients with type 2 diabetes mellitus (T2DM) in the community. Methods From January 2012 to April 2017, 1625 patients of T2DM (766 males and 859 females with an average age of 62.9 years) were treated in Xinjiekou Community Health Service Center. They were managed by a contracted general practitioner team for one consecutive year, including initial assessment, patient education, disease follow-up and annual assessment. Four classes of diabetes and hypertension knowledge were given, patient self-assessment and nursing scoring were conducted before and after the education, including healthy life habits, diet and exercise. Family self-assessment, knowledge and skills in monitoring blood pressure, blood glucose, drug use, and risk prevention were carried out. Data collection and analysis were based on quarterly and annual follow-up tables. Results Before and after management, the mean BMI of 1625 patients was (25.0± 3.1) and (24.6 ± 3.1) kg/m2 (t=13.25, P=0.001), systolic blood pressure was (133.3 ± 10.0) and (122.7 ± 7.7) mmHg (1 mmHg=0.133 kPa, t=43.84, P=0.001), diastolic blood pressure was (82.7 ± 22.1) and (76.1 ± 13.5) mmHg (t=10.46, P=0.001), fast blood glucose was (7.2±2.5) and (6.2±0.9) mmol/L (t=18.50, P=0.001), 2 h-postprandial blood glucose was (9.1±2.1) and (7.8±1.9) mmol/L (t=23.39, P=0.001) and glycated hemoglobin (HbA1c) was (6.8 ± 1.1) and (6.3 ± 2.2) ％ (t=8.68, P=0.001), all were decreased significantly after management. After management the rates of HbA1c, fasting blood glucose and 2 h-postprandial blood glucose reached the standard were increased (χ2=345.57, P=0.001;χ2=235.13, P=0.001;χ2=354.28, P=0.001). The rates of aerobic exercise, the proportion of 3-5 times a week, exercise time 30-60 minutes/time increased (χ2=1245.58, P=0.001; χ2=158.38, P=0.001; χ2=264.26, P=0.001). The rates of smoking, drinking, eating fried food, saltiness food, sweetness food decreased (χ2=13.92, P=0.001; χ2=23.88, P=0.001; χ2=311.71, P=0.001; χ2=674.31, P=0.001; χ2=247.86, P=0.001). After management, the rates of blood pressure, blood glucose and waist circumference self-measurement; using food scales, staple measuring, salt spoon, oil spoon and kettle, pedometer were increased significantly. The scores of health, ability, knowledge and comprehensive evaluation after management were also increased significantly (40.3± 6.0 vs. 20.9±11.0, t=76.46, P<0.001;36.4±7.8 vs. 19.4±9.2, t=75.99, P<0.001;14.8±3.3 vs. 7.6±4.4, t=51.03, P<0.001;91.5±11.7 vs. 48.0±20.3, t=89.54, P<0.001). Conclusion The general practitioner team can effectively improve the self-management ability and achieve better clinical effect in T2DM patients.
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Objective Exploring theoretical teaching model of chronic diseases management of preventive medicine undergraduates,to provide feasible suggestions to improve the theoretical teaching of the chronic disease management ability of preventive medicine specialty in China so that graduates can better adapt to chronic diseases management work.Methods On the basis of reading a large number of relevant literature both at home and abroad,the research team designed questionnaires,and conducted a questionnaire survey on 190 respondents who engaged in chronic diseases management or teaching in central China.The content includes the understanding of the importance of training chronic disease management ability in undergraduate education of preventive medicine and the constitution and training mode of undergraduates' chronic disease management ability.EpiData 3.1 software was used to input survey data,SPSS 23.0 software was used for statistical description analysis,and the usage ratio and component ratio were used for statistical description analysis.Results The survey found that more than 50％ of the respondents believed that training students with chronic disease management should focus on prevention,intervention services and health promotion ability,and chronic disease modules need to be added to undergraduate courses in preventive medicine.Conclusions preventive medicine undergraduates need to be improved,and medical colleges should change teaching model to increase undergraduates' ability of chronic diseases management.
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Management of oral diseases during pregnancy prefers to be a comprehensive oral health care strategy throughout pre-pregnant, pregnant and prenatal stages. It provides guidance not only to promote the overall health in pregnant women, but also concern fetus development and children's oral health. Pregnancy is a time of particular vulnerability in terms of oral health due to complex physical and physiological changes. Physicians and dentists are responsible for providing professional medical care and treatment following clinical guidelines especially for pregnancy. It is also an opportune time in pregnancy to educate women about oral health care and preventing oral problems in young children. This article reviews the commonly occurring oral problems and their pathogenesis during pregnancy, dental procedures that can be carried out by physicians and preventive strategies that could be helpful in promoting oral health in both pregnant women and young children.
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Female , Humans , Pregnancy , Dental Care , Mouth Diseases , Oral Health , Prenatal CareABSTRACT
Objective To analyze and assess the major functions of medical APP by investigating its application in self management of chronic diseases. Methods The 3 major functions of APP were analyzed, including data record and condition assessment, medical consultation, and life therapy. Results The medical APP possesses its basic functions for chronic diseases management. However, it lacks of practicality and convenience and its homogenization is severe. Conclusion The APP +hardware +cloud medical management model should be promoted by making use of the Internet + medical technology, the supervision of mobile medical APP should be strengthened, the mobile information management mechanisms of chronic diseases should be perfected, and the self management efficiency of patients with chronic diseases should be improved.