Patient Education with New Media Integration Self-Management Support Model Improves Therapeutic Outcomes of Rosacea Patients.

Objective: To retrospectively analyze the factors influencing the treatment of rosacea patients with regular follow-up by self-management support in the new media chronic disease management model, to explore the effect of self-management support and to provide an objective basis for clinical application. Methods: Female patients with rosacea who were regularly followed up for more than 6 months at the rosacea follow-up clinic of the Department of Dermatology, West China Hospital, Sichuan University, from March 2022 to June 2023, with erythema and capillary dilation as the main clinical phenotype, met the rosacea diagnostic criteria of the American Rosacea Expert Committee 2017 edition, and received medications recommended by the Chinese Rosacea Treatment Guidelines (2021 edition). A total of 125 patients were treated with combined photobiomodulation therapy (PBMT), and the patients were divided into a standardized group (CEA<1, IGA<1) and a non-standardized group (CEA≥1, IGA≥1) based on significant rosacea efficacy (CEA<1, IGA<1) within 6 months. The age, gender, education level, duration of rosacea, treatment regimen, education intensity, CEA, and IGA baseline data were compared between the two groups, and logistic regression analysis was performed to analyze the factors influencing the significant efficacy of rosacea. Results: There was a significant difference in the mean length of education between the two groups (P<0.05), and the differences between the rest of the baseline information of the two groups were not statistically significant (P>0.05). Logistic regression analysis showed that the variable that significantly influenced the efficacy of treatment was the mean length of education (≥130.5 min/month), and the intensity of education was significantly associated with the efficacy of treatment. Conclusion: Self-management support in the new media chronic disease management model has a positive impact on the treatment of rosacea patients.

Practice of cerebrocardiac health advisors training / 中华医院管理杂志

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies.

INTRODUCTION: Heart failure (HF) is an emerging epidemic with poor disease outcomes and differences in its prevalence, etiology and management between and within world regions. Hypertension (HT) and ischemic heart disease (IHD) are the leading causes of HF. In Suriname, South-America, data on HF burden are lacking. The aim of this Suriname Heart Failure I (SUHF-I) study, is to assess baseline characteristics of HF admitted patients in order to set up the prospective interventional SUHF-II study to longitudinally determine the effectiveness of a comprehensive HF management program in HF patients. METHODS: A cross-sectional analysis was conducted of Thorax Center Paramaribo (TCP) discharge data from January 2013-December 2015. The analysis included all admissions with primary or secondary discharge of HF ICD-10 codes I50-I50.9 and I11.0 and the following variables: patient demographics (age, sex, and ethnicity), # of readmissions, risk factors (RF) for HF: HT, diabetes mellitus (DM), smoking, and left ventricle (LV) function. T-tests were used to analyze continuous variables and Chi-square test for categorical variables. Differences were considered statistically significant when a p-value <0.05 is obtained. RESULTS: 895 patients (1:1 sex ratio) with either a primary (80%) or secondary HF diagnosis were admitted. Female patients were significantly older (66.2 ± 14.8 years, p < 0.01) at first admission compared to male patients (63.5 ± 13.7 years) and the majority of admissions were of Hindustani and Creole descent. HT, DM and smoking were highly prevalent respectively 62.6%, 38.9 and 17.3%. There were 379 readmissions (29.1%) and 7% of all admissions were readmissions within 30 days and 16% were readmissions for 31-365 day. IHD is more prevalent in patients from Asian descendant (52.2%) compared to African descendant (11.7%). Whereas, HT (39.3%) is more prevalent in African descendants compared to Asian descendants (12.7%). There were no statistically significant differences in age, sex, ethnicity, LV function and RFs between single admitted and readmitted patients. CONCLUSION: RF prevalence, ethnic differences and readmission rates in Surinamese HF patients are in line with reports from other Caribbean and Latin American countries. These results are the basis for the SUHF-II study which will aid in identifying the country specific and clinical factors for the successful development of a multidisciplinary HF management program.

Evaluation of an integrated HIV and hypertension management model in rural south africa: a mixed methods approach.

Background: A summary of Soter Ameh's PhD thesis titled, 'An integrated HIV and hypertension management model in rural South Africa: A mixed methods approach' is presented here. In responding to the dual high burden of non-communicable diseases (NCDs) and HIV in South Africa, the national government initiated an integrated chronic disease management (ICDM) model in health facilities as a pilot programme. The aim of the ICDM model is to leverage the successes of the innovative HIV treatment programme for NCDs to improve the quality of care and health outcomes of adult patients.Objectives: The specific objectives of this study were to: (1) determine the quality of care provided in the integrated model in 2013, (2) describe patients' and operational managers' perceptions of quality of care in the integrated model in 2013, and (3) assess effectiveness of the integrated model in controlling CD4 counts (>350 cells/mm3) and blood pressure (<140/90 mmHg) of patients from 2011 to 2013.Methods: A combination of quantitative and qualitative methods was used to assess and describe the quality of care in the model. Effectiveness of the model in controlling patients' blood pressure (BP) and CD4 counts was assessed in selected PHC facilities in the Bushbuckridge municipality in Mpumalanga province, South Africa.Results: The findings showed the suboptimal quality of care in five of the eight priority dimensions of care used as leverage for the NCD programme. The ICDM model had a small but significant effect on BP control for hypertension patients receiving treatment.Conclusions: The HIV programme needs to be more extensively leveraged for hypertension treatment to achieve an optimal BP control in the study area. These findings could have policy relevance for low- and middle-income countries currently undertaking proof of concept studies to demonstrate the feasibility of implementing an integrated chronic disease care model.

Research progress on chronic disease management / 预防医学

@#Recently,the incidence of chronic disease has been increasing rapidly every year,which contributes to heavy burdens on society. Chronic disease management（CDM）has become an effective solution. At present,CDM in China is still at an early age,without a widely accepted and efficient model for lack of theoretic and practical support. By analyzing and comparing CDM models in China and abroad,we summarizes that CDM in China needs to be guaranteed by government and law,strengthened by the construction of medical team,promoted by an integrated service network,and implemented by hierarchical diagnosis and treatment of multi-departments.

Application of nurse-led integrated specialized disease management model in the follow-up of peritoneal di-alysis patients / 医学研究生学报

Objective Peritoneal dialysis can be done at home , however , its clinical follow-up quality is lower compared with hemodialysis due to the lack of detailed follow-up system and professional management team for post-discharge nursing care .The article aimed to explore the effect of a nurse-led integrated specialized disease management model in the follow-up of peritoneal dialysis patients . Methods Nurse-led integrated specialized disease management model was provided for 270 patients with peritoneal dialysis (PD) from January 2012 to May 2013.Self-designed questionnaire on diasease knowledge and self-care assement questionnaire were used for patients to evaluate their self-care ability and understanding of disease knowledge .Regular follow-up continued . Results The patients′understanding of disease knowledge was on the rise at 1st day before discharge, 1st month and 3rd months after discharge. After the application of nurse-led integrated specialized disease management model , the patients′regular clinical follow-up rate was in-creased from 78.3% to 88.6%.The patients′self-care ability improved gradually at 1st day before discharge , 1st month and 3rd months after discharge , which was of significant differences . Conclusion The nurse-led nurse-led integrated specialized disease management model can improve peritoneal dialysis patients′self-care ability and reduce their medical expense , which is of clinical sig-nificance .