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1.
China Pharmacy ; (12): 2167-2171, 2022.
Article in Chinese | WPRIM | ID: wpr-941463

ABSTRACT

OBJECTIVE To provide reference for chronic disease management in grass-root institution . METHODS System structure design and audit class setting of the regional pretrial center in Changning district of Shanghai were introduced. The number of prescriptions/medical orders from the start of application to February 28,2022 were counted. The prescriptions/medical orders intercepted by the system ,prescriptions/medical orders intervened by physicians ,chronic disease types and drug use of regional multiple chronic diseases were counted and analyzed. RESULTS Compared with the data when the center was on line in September 2021,total qualified rate of prescriptions/medical orders (97.67% vs. 86.42%)significantly increased ,the number of prescriptions/ medical orders intercepted by the system and intervened by physicians decreased by 55.39% and 72.67% in February 2022, respectively. The top five diseases were hypertension (26.52%),coronary heart disease (20.53%),sleep disorders (16.71%),diabetes(15.24%)and bone diseases (14.09%). Among them , there were many problematic prescriptions involving coronary heart disease ,sleep disorder and bone disease. CONCLUSIONS The incidence of chronic diseases among community residents remains high. In addition to common chronic diseases such as coronary heart disease ,hypertension and diabetes ,the incidence of sleep disorders and bone diseases is also increasing. With the help of the regional pretrial center ,the focus of chronic disease management can be adjusted timely ,drug supervision can be carried out in real time so as to improve the level of rational drug use in grass-root institution.

2.
China Pharmacy ; (12): 2028-2031, 2022.
Article in Chinese | WPRIM | ID: wpr-936984

ABSTRACT

Remote pharmaceutical care refers to the process that pharmacists provide pharmaceutical care to patients remotely through information technology. Remote pharmaceutical care in China starts late and develops slowly. Therefore ,this paper discusses the pharmaceutical care modes that pharmacists at home and abroad can provide under the remote mode by collecting literature. The results show that foreign remote pharmaceutical care starts early and is relatively mature. The service mainly included remote follow-up and intervention ,24-hour online prescription and order review ,24-hour online drug reorganization ,and guidance on rational drug use in remote areas or community hospitals. The service population covers patients with cardiovascular disease , diabetes,asthma,AIDS and so on. Some hospitals have established an integrated pharmaceutical care system of “Internet+Medical Consortium”in China ,with which pharmacists can provide patients with pharmaceutical care such as remote follow-up and intervention,drug consultation and so on. With the promotion of telemedicine ,domestic pharmacists can gradually expand the scope of services ,expand pharmaceutical services such as remote consultation and remote popular science push ,and realize the sharing of high-quality pharmaceutical care for the whole people.

3.
Article in Chinese | WPRIM | ID: wpr-934575

ABSTRACT

Objective:To investigate the development of hypertension specialty and chronic disease management of county-level hospitals in China, for reference in improving the standardized chronic disease management level of hypertension in the counties.Methods:From September to November 2020, a questionnaire survey on 597 county-level hospitals in 24 provinces was conducted on a voluntary basis. The survey covered such areas as the setup of hypertension specialty, team building of professionals and the management regulations of chronic hypertension of the hospital. The survey data were analyzed by descriptive statistics.Results:Among the 597 county-level hospitals, 54(13.5%) hospitals had independent hypertension departments, 147(24.6%) had hypertension clinics, and 143(24.0%) hospitals had hypertension beds. 431(72.2%) hospitals had hypertension diagnosis and treatment process in outpatient clinics, 454(76.0%) hospitals had hypertension diagnosis and treatment process in wards, and 535(89.6%) hospitals had graded diagnosis and treatment process of hypertension. 473(79.2%) hospitals had established county medical alliance as the lead unit, including 167 compact medical alliances. 97.7% of the hospitals were equipped with basic hypertension risk stratification screening items, and 63.8% could carry out primary screening of secondary hypertension.Conclusions:The pattern of chronic diseases management of hypertension in county-level medical institutions has basically taken shape, but there is still room for improvement. In the future, we should focus on the construction of professional teams of hypertension, the standardized management of diagnosis and treatment of hypertension, and a smoother path of tiered medical service, so as to increase the health management level of hypertension in China.

4.
Chinese Journal of Geriatrics ; (12): 614-618, 2022.
Article in Chinese | WPRIM | ID: wpr-933133

ABSTRACT

The management model of chronic noncommunicable diseases(chronic diseases)in the elderly is related to the outcome and outcome of patients.The main advantages of chronic disease management in foreign countries are the burden of medical insurance, the interconnection of medical institutions in a limited scope, the primary health workers leading, and the active participation of patients.Although the form of chronic disease management in the community is also included in China and guidance documents have been issued, there is still a need for improvement in policy implementation, information system, community resources and patient education.

5.
Article in Chinese | WPRIM | ID: wpr-932986

ABSTRACT

Objective:To explore the application of the mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC) in the chronic disease management of adult patients with severe asthma.Methods:Thirty patients with severe asthma without a smoking history who received treatment and chronic disease management in the First Affiliated Hospital of Guangxi Medical University from December 2018 to December 2020 and met the inclusion criteria were selected as the research subjects. Their clinical symptoms, LCQ-MC, asthma control test (ACT), mini asthma quality of life questionnaire (MiniAQLQ), visual analogue scale (VAS) and lung function test were recorded. The reliability of LCQ-MC and its correlation with ACT, MiniAQLQ, VAS and lung function were analyzed.Results:Among the 30 patients, there were 14 males and 16 females, with an average age of (50.5±10.5) years old and a medical history of (38.3±15.5) years. The main manifestations were cough which was observed in 29 cases (96.7%), wheezing in 25 cases (83.3%), nasal symptoms in 14 cases (46.7%) and chest tightness in 11 cases (36.7%). All lung functions were consistent with the diagnosis of asthma. The total score of LCQ-MC was (16.1±4.2), in which the physiological, psychological and social dimensions were (5.0±1.2), (5.6±1.6), (5.5±1.7), respectively; and ACT (18.9+5.5), MiniAQLQ (4.9±1.4), VAS (33.5±32.4). The Cronbach′s α for the questionnaire was more than 0.70, and the results were positively correlated with ACT and MiniAQLQ ( r=0.553, 0.593, P=0.002, 0.001), negatively correlated with VAS ( r=-0.762, P<0.001). The correlations between LCQ-MC and these scores were consistent with the results after 6 months. Conclusion:Cough is an important symptom of severe asthma, and LCQ-MC can be effectively used for evaluation and chronic disease management of adult patients with severe asthma.

6.
Article in Chinese | WPRIM | ID: wpr-930631

ABSTRACT

The chronic disease management of rheumatoid arthritis has been popularized and applied in China. This article will review the application and research progress of different chronic disease management models, including chronic care mode, chronic disease self-management, transitional care mode, community-based chronic disease management, and "internet + chronic disease management" in rheumatoid arthritis patients in China, and compare the advantages and disadvantages of different intervention models, in order to provide a theoretical basis for exploring the chronic management of rheumatoid arthritis under different regional medical resources.

7.
Article in Chinese | WPRIM | ID: wpr-929521

ABSTRACT

@#Early childhood caries (ECC) is not only harmful to children's oral cavity and even the whole body, the government and relevant health departments pay more and more attention to the prevention and treatment of early childhood caries. However, at present, the primary treatment for ECC is the traditional filling therapy. The chronic disease management model can conduct regular testing of chronic non-communicable diseases and their risk factors, and provide long-term and effective professional management to patients by supervision and advice by doctors, nurses and pharmacists. This model has a good effect on slowing down the development of the disease, improving the quality of life of patients and saving public health resources. As a common chronic non-communicable disease, ECC is very suitable for prevention and treatment through chronic disease management. In recent years, chronic disease management models have also been increasingly used in the management of caries. The current common chronic disease management models include the chronic care model, innovative care for chronic condition, and British chronic disease management system models. And above models have certain applications in the management of ECC. How to establish the caries risk assessment system suitable for the diagnosis and treatment model of our country, and how to screen the children with high risk of caries by step-by-step prevention and control network for personalized prevention needed to be further studied in the future.

8.
China Pharmacy ; (12): 1627-1633, 2021.
Article in Chinese | WPRIM | ID: wpr-881467

ABSTRACT

OBJECTIVE:To su mmarize the achievements and shortcomings of chronic disease management policies in China , and to provide reference for the formulation and improvement of the policy. METHODS :Totally 109 documents related to chronic disease management issued by the State Council and various ministries and commissions from 2009 to 2020 were processed by text mining method. PMC index evaluation model of chronic disease management policy was established. Sixteen typical chronic disease management policies were quantitatively evaluated and analyzed by 10 first-level indicators and 40 second-level indicators. RESULTS:Among the 16 policies,10 were of excellent level and 6 were of acceptable level. The average PMC score was 7.243, which was generally acceptable level but still had large room for improvement. By comparing two representative policies ,it was found that the main reasons for the policies with low scores were the lack of long-term development planning ,the absence of “Internet + chronic disease management ”new model and other contents ,and the lack of talent incentive and legal guarantee measures. CONCLUSIONS :Chronic disease management policy has been improved ,and it can be further improved from the aspects of policy prescription ,policy content and incentive mode.

9.
Article in Chinese | WPRIM | ID: wpr-908595

ABSTRACT

The pathogenesis, diagnosis and management of glaucoma are complex and the population with glaucoma is huge in China now.With the development and popularization of cataract surgery, the visual disability and blindness caused by glaucoma are becoming more and more prominent.With the advantages of the combination of clinical pathway and public health in China, it is necessary to pay close attention to the following focuses of the prevention and control of glaucoma according to China's national conditions.(1)The awareness of glaucoma prevention and control should be strengthened, and the relevant screening technology and the construction of special team should be promoted to achieve the goal of early screening, early diagnosis and early treatment.(2)The diagnosis and treatment guidelines for glaucoma should be further well-established to promote the application of appropriate technologies in glaucoma diagnosis and treatment.In addition, glaucoma should be included in the chronic disease management system to accelerate the establishment and improvement of a three-level medical network system.(3)At the same time, the rehabilitation measurement for the patients with glaucomatous low vision should be reinforced to reduce the glaucomatous blindness rate.(4)The whole-process management for glaucoma patients should be enhanced, and nationwide popular science education should be well implemented.

10.
Chinese Acupuncture & Moxibustion ; (12): 1221-1224, 2021.
Article in Chinese | WPRIM | ID: wpr-921036

ABSTRACT

OBJECTIVE@#To compare the therapeutic effect on bronchial asthma between presence of skin reaction and the absence of skin reaction after acupoint application.@*METHODS@#Sixty-one patients with bronchial asthma were treated with acupoint application during the hottest periods of summer ("dog days"). The acupoints included Dingchuan (EX-B 1), Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20) and Shenshu (BL 23). The treatment was given once every 7 days, with the herbal plaster remained for 6 h each time, and 4 treatments were required totally. According to the local skin reaction after acupoint application, a skin reaction group (30 cases, 2 cases dropped off) and a non-skin reaction group (31 cases) were divided. Separately, before treatment and 1 year after treatment, using chronic disease management platform of asthma, the number of asthma attacks, the score of asthma control test (ACT) and the score of asthma quality of life questionnaire (AQLQ) were recorded online. Besides, the therapeutic effect was observed in the two groups 1 year after treatment.@*RESULTS@#One year after treatment, the number of asthma attacks was reduced as compared with that before treatment in the patients of either group (@*CONCLUSION@#In treatment of acupoint application for bronchial asthma, the clinical therapeutic effect is better in the patients with local skin reaction after acupoint application. The chronic disease management platform of asthma is convenient for online evaluation.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Asthma/therapy , Disease Management , Humans , Quality of Life
11.
Article in Chinese | WPRIM | ID: wpr-912078

ABSTRACT

Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.

12.
Article in Chinese | WPRIM | ID: wpr-908871

ABSTRACT

Objective:To study whether the "combination of medical care and pension" service model can effectively control the development of chronic disease in the elderly and reduce the direct economic burden caused by the disease.Methods:A total of 180 elderly participants who received the "combination of medical care and pension" service model for chronic disease management in Chongqing, China were investigated and analyzed statistically. Epidata 2.0 was used for data entry, SPSS 20.0 was used for data analysis, and paired sample t test was used for comparison between groups. Results:After 12 months of chronic disease management, hospitalization events and expenses of the elderly were reduced, among which the number of hospitalization was reduced by 0.24 timed on average, the length of hospitalization was reduced by 10.41 days on average, and the hospitalization expenses were reduced by 11 144 yuan on average. The direct economic burden due to chronic diseases was reduced by approximately 8 844.5 yuan, accounting for 33.8% of the average cost of hospitalization for the elderly without the application of the model.Conclusion:The chronic disease of the elderly is well controlled by chronic disease management through the "combination of medical care and pension" service model.

13.
Article in Chinese | WPRIM | ID: wpr-876217

ABSTRACT

Objective An analysis of informationized multi-platform big data was conducted to learn about the quality change of health management data for hypertension and diabetes patients in Baoshan District of Shanghai since 2017.The result provided important information for further evaluation of the effect of quality control measures, and the prevention and management of chronic diseases. Methods Height, weight, blood glucose level, diagnosis and treatment information were collected from different databases of patients with hypertension and diabetes in Baoshan District from 2017 to 2019, and the consistency of the data from different sources was analyzed. Results Both the percentages of weight and height inconsistency among patients with hypertension and diabetes together were lower in 2019 than in 2017 (10.99% vs 18.72%, χ2=822.38, P < 0.001 and 0.86% vs 2.74%, χ2=347.03, P < 0.001, respectively).In 2019, the percentage of registered hypertensive patients with abnormal traceability from diagnosis was higher than that in 2017 (12.67% vs 11.72%, χ2=4.01, P=0.045).Similar results were also obtained in patients with diabetes.Analysis of glycated hemoglobin value last position in diabetic patients showed that the coefficient of variation of the last position composition ratio of the value in 2019 was significantly lower than that in 2017 (0.19 vs 0.31).The ratio in patients with the last position of glycosylated hemoglobin value of 0 was lower in 2019(4 701 cases, 12.72%) than that in 2017 (9 485 cases, 17.14%), and the difference was statistically significant. Conclusion The study result shows an improvement in quality management of hypertension and diabetes in Baoshan District of Shanghai.Information technology should be more widely used in promoting technical standardization, strengthening technical training, data quality control and effect evaluation.

14.
Article in Chinese | WPRIM | ID: wpr-782393

ABSTRACT

Objective To evaluate the role of clinical pharmacists on the pharmacological monitoring and management of diabetic patients. Methods 406 adult outpatients with diabetes in outpatient were selected as research object. The patients were given the questionnaire and intervened with diabetes education and management by the clinical pharmacist regularly. The patient’s knowledge of the diabetes medication before and after intervention, blood glucose and glycosylated hemoglobin values, treatment compliance, non-reserved outpatient visit, emergency, hospitalization, etc. were compared and statistically analyzed. Results After pharmacy intervention, the patients' knowledge of diabetes and drug-related information, treatment compliance, blood glucose and glycosylated hemoglobin were better than before intervention, P<0.01. Non-reserved outpatient visits and emergency cases were better than before intervention, P<0.05. There are significant differences. Conclusion Clinical pharmacists carry out diabetes chronic disease management and build a clinical pharmacist-led chronic disease management model, which helps to promote standardized treatment, improve patient compliance, promote rationalized medication, achieve the goal of controlling blood sugar and reduce complications.

15.
China Pharmacy ; (12): 745-750, 2020.
Article in Chinese | WPRIM | ID: wpr-817557

ABSTRACT

OBJECTIVE:To evaluate the effect of clinical pharmacists participating in chronic disease management for chronic heart failure (CHF)patients. METHODS :Totally 160 patients with CHF in our h ospital from Jan. 2016 to Dec. 2017 were divided into intervention group (80 cases)and control group (80 cases)according to random number table method. The patients received CHF routine examination and drug treatment at admission ;on this basis ,the patients in the intervention group received clinical pharmacist chronic disease management as inpatient pharmaceutical care ,medication education at discharge and pharamceutical follow-up at discharge. The cardiac function indexes (NYHA cardiac function classification ,LVEF,NT-proBNP,LVDd), comprehensive self-care ability (scores of self-care ability ,drug compliance ,understanding of disease-related knowledge ,and total score of comprehensive self-care ability ),and life quality (emotional score ,symptom score ,social restriction score ,and total score of life quality )at admission ,discharge and 6 months after discharge ;economic indicators (total hospitalization expenses , hospitalization time ,drug expenses and drug proportion )during hospitalization ;readmission and case fatality within 6 months after discharge were compared between the two groups. RESULTS :At admission ,there was no significant difference in the above indicators between 2 groups(P>0.05);at discharge ,except for LVEF ,emotional score and social restriction score ,the other indicators in 2 groups were significantly improved ,compared with at admission (P<0.05);six months after discharge ,the above indicators of 2 groups were significantly improved compared with at admission ,and LVEF ,LVDd,drug compliance score ,score of understanding of disease-related knowledge ,total score of comprehensive self-care ability ,emotion score ,symptom score ,total score of life quality in the intervention group were significantly better than control group (P<0.05). There was no significant difference in the total hospitalization expenses ,hospitalization time ,drug expenses and drug proportion between 2 groups(P> 0.05). Within 6 months after discharge ,the readmission rate of the intervention group was 14.29%,which was significantly lower than that(29.33%)of control group (P<0.05). There was no significant difference in case fatality rate between 2 groups(P> 0.05). CONCLUSIONS :The participation of clinical pharmacists in chronic disease management of CHF patients can significantly improve the cardiac function indexes ,comprehensive self-care ability and quality of life ,and reduce the readmission rate.

16.
China Pharmacy ; (12): 622-626, 2020.
Article in Chinese | WPRIM | ID: wpr-817322

ABSTRACT

OBJECTIVE:To provide reference for chronic disease man agement service develophed in social pharmacy. METHODS:Questionnaire about the Status Quo of Chronic Disease Management and Service in Social Pharmacy of Chengdu was designed,using the quota sampling method ,social pharmacies in five main urban areas of Chengdu were selected from May to July,2018 to conduct a questionnaire survey (one questionnaire by each social pharmacy ) on the basic situation of social pharmacies,the development of chronic disease management services ,the cognition of chronic disease management services ,and the challenges faced by chronic disease management services ,and suggestions were proposed. RESULTS & CONCLUSIONS :A total of 272 questionnaires were sent out ,and 252 valid questionnaire were actually collected (effective recovery rate of 92.65%). Totally 189 sample pharmacies (75.00%) had carried out chronic disease management services ,of which 112 (59.26%) pharmacies had been launched for 1-3 years;87(46.03%)had set up service areas ;68(35.98%)had full-time staff ,and 54 (28.57%)had part-time staff ,most of which were licensed pharmactists. 116(61.37%)had trained related staff for 1-2 times per year. 176(93.12%)pharmacies could provide services such as basic indicator testing (176,93.12%),establishing health records (142,75.13.%),and rational medication guidance for patients (163,86.24%). According to the survey ,the substantial benefits of chronic disease management services included changing the health status of patients (163,86.24%),improving patients ’trust in the pharmacy and staff (141,74.60%),improving patients ’quality of life (129,68.25%),etc. More than 50% of pharmacies faced the challenges of limited number of licensed pharmacists (102,53.97%),difficulty in establishing professional teams (112, 59.26%),and lack of trust in services (101,53.44%). The current chronic disease management service of social pharmacy in Chengdu is in the initial stage of active exploration ,which can bring many benefits to patients and pharmacies ,and is conducive to the promotion of medical and health policies ,but there are some weak links at the same time. It is suggested that relevant government departments should strengthen the support ofpolicies and regulations , and social pharmacies constantly 85501387。 E-mail:2191043137@qq.com improve professional level and rely on the advantages of “Internet + ”to meet the diverse needs of the public for pharmaceutical care ,and publicity efforts are intensified to · enhance the awareness and participation of patients with chronic diseases.

17.
Article in Chinese | WPRIM | ID: wpr-791598

ABSTRACT

Objective To evaluate the effects of chronic disease management on carotid atherosclerosis. Methods From May 2016 to October 2016, 500 subjects with carotid atherosclerosis diagnosed by ultrasound at the Physical examination center of the First Hospital of Jilin University were enrolled. The participants were aged 55?65(60.7±3.5) years. They were divided into the control group (n=250) and intervention group (n=250) using a random number table; a total of 20patients, 13 in the control group and 7 in the intervention group, were lost to follow-up at the end of the study. The control group only received anti-atherosclerosis treatment, while the intervention group underwent additional chronic disease management, and a 1-year follow-up study was conducted. The health of all the subjects was assessed at the beginning of the study and after the study, based on the health file. The chi-square test, two independent sample t-tests, and rank sum test were used to evaluate the effect of chronic disease management on carotid atherosclerosis. Results After 1 year of intervention, the proportion of patients with an unhealthy lifestyle (smoking, excessive drinking, high-salt diet intake, high-fat diet intake, lack of exercise, and overweight/obesity) decreased in the intervention group(10.3%, 13.1%, 7.8%, 8.6%, 6.2%, 28.0%, vs. 28.8%, 35.0%, 21.0%, 22.6%, 13.2%, 39.5%; χ2=26.49, 33.01, 17.09, 18.03, 6.80, 7.21; P<0.05), while the drug compliance increased(44.4% vs. 35.4%, χ2=4.15, P<0.05), and the total cholesterol (TC), triglyceride (TG), low density lipoproteincholesterol (LDL-C), fasting plasma glucose (FPG), uric acid (UA) and blood pressure (BP) compliance rate also increased (91.8%, 73.3%, 83.1%, 83.1%, 52.3%, 76.5%, 74.1%, 60.5%, vs. 67.5%,72.8%,28.0%,58.8%, respectively; χ2=26.86, 8.92, 15.97, 7.49, 29.81, 17.39, respectively; P<0.05); all indicators, except the drug compliance control rate, were better than those in the control group. After 1 year of intervention, the degree of carotid atherosclerosis in the intervention group was significantly reduced compared to that in the control group. Conclusions Chronic disease management could effectively interfere the control risk factors of atherosclerosis, such as smoking, drinking, obesity or overweight, BP, levels of FPG, blood lipids, and UA, improve drug compliance, delay the progression of atherosclerosis and provide a basis for the construction of the atherosclerosis management model.

18.
Article in Chinese | WPRIM | ID: wpr-803487

ABSTRACT

Objective@#To construct a community pathway of chronic disease management for chronic obstructive pulmonary disease (COPD), which provided a theoretical basis for community management of chronic disease in COPD.@*Methods@#Under the theoretical framework of the PDCA cycle management method, the questionnaire was formed with reference to the clinical pathway. This study conducted two-rounds of expert correspondence by using the Delphi method.@*Results@#After two rounds of expert letters, the effective recovery rate of the volume was 100% (15/15), the authoritative coefficient was 0.85, the familiarity coefficient was 0.76, and the judgment coefficient was 0.93, the path of COPD chronic disease management community was ultimately determined for 6 first-level indicators, including assessment, planning, implementation, variation, evaluation and feedback, 19 second-level indicators and 44 third-level indicators. The coordination coefficient of indicators was 0.12, 0.05, 0.12, and the coordination of expert opinions of the third-level indicators was statistically significant (P<0.05).@*Conclusion@#The community path of COPD chronic disease management has been tested by experts, with concentrated opinions and scientific and reliable, which provides a reference for COPD chronic disease community management.

19.
Article in Chinese | WPRIM | ID: wpr-800883

ABSTRACT

The pre-during-post hospital closed-loop management of chronic diseases is an efficient way to upgrade the current chronic disease management level. The authors described the feasibility, what to build and imperative problems in implementing such a closed-loop management in primary level in Ningxia. The introduction focused on the construction of a chronic disease management path for multiple diseases, the implementation of a closed-loop management model for chronic diseases based on the " three in one model(specialist-family physician-health manager)" , the promotion of primary physician training and standardization management level, as well as the establishment of a community-centered three-level prevention and treatment system for chronic diseases. These efforts aim at promotion of chronic disease management outcomes, elevation of patients′ health and quality of life, and minimization of people′s economic burden.

20.
China Pharmacy ; (12): 2115-2120, 2019.
Article in Chinese | WPRIM | ID: wpr-817191

ABSTRACT

OBJECTIVE: To evaluate the effects of clinical pharmacist-led ischemic stroke management, and to provide reference for chronic disease management. METHODS: Totally 184 patients with ischemic stroke who were hospitalized in neurology department of the First Hospital of Hebei Medical University from May to August 2018 were included prospectively, and then divided into control group (92 cases) and intervention group (92 cases) by random number method. Control group did not receive clinical pharmacist intervention. In the intervention group, clinical pharmacists were the leader in the pharmaceutical care during the hospitalization, the medication education at discharge, and pharmacy follow-up after discharge. The rate of medication compliance (antiplatelet drugs, antihypertensive drugs, hypoglycemic drugs and lipid-lowering drugs) and the rate of secondary prevention and control indicators of ischemic stroke, such as blood pressure, blood glucose [glycated hemoglobin (HbA1c)] and blood lipid [low-density lipoprotein cholesterol (LDL-C)] were investigated between 2 groups at 6 months after discharge. The incidence of adverse drug reaction and the rate of rehospitalization were compared between 2 groups at 6 months after discharge. RESULTS: The number of patients in the intervention group and the control group was 84 and 82, respectively. At 6 months after discharge, the compliance rate of antiplatelet drugs in the intervention group was 96.43%, which was higher than 95.13% of control group, but the difference was not statistically significant. The good compliance rates of antihypertensive drugs, hypoglycemic drugs and lipid-lowering drugs in the intervention group were 92.86%, 91.67% and 77.38%, which were higher than 78.57%, 69.70% and 60.98% of control group, with statistical significance (P<0.05). The qualified rate of index of blood pressure was 89.29% in intervention group, which was higher than 76.79% of control group, but the difference was not statistically significant. The qualified rates of HbA1c and LDL-C in the intervention group were 80.56% and 66.67%, which were higher than 57.58% and 48.785 of control group, with statistical significance (P<0.05). The incidence of total adverse drug reactions in the intervention group was 15.48%, which was lower than 20.73% of control group, but the difference was not statistically significant. The total rehospitalization rate in the intervention group was 7.14%, which was lower than 17.86% of control group, the difference was statistically significant (P<0.05). CONCLUSIONS: The management of ischemic stroke patients with clinical pharmacists as the leading factor can improve the patient’s medication compliance, improve the qualified rate of secondary prevention and control indicators of ischemic stroke, and reduce the rate of rehospitalization.

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