教育讲义对肥胖患者随访预约依从率的影响。

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Quality Management in Health Care Pub Date : 2024-11-29 DOI:10.1097/QMH.0000000000000494
Nicolas Fedirko, Kristi Jo Wilson, Roxanne Buterakos, Alyssa Pechta
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引用次数: 0

摘要

背景和目的:随访预约的依从率是术后袖胃切除术(SG)患者的一个问题。如果没有持续的加强和监测患者的进展,患者往往会体重反弹,所有的医疗改进都付之一篑,并且无法为潜在的并发症接触患者。患者在其长期的肥胖生活方式中需要大量的强化,而缺乏一致的提醒可能导致SG患者的随访不遵守和再犯。随着时间的推移,随访预约依从率降低。减少随访可导致并发症(如无症状性食管炎)的风险增加,目前建议术后3年进行食管胃十二指肠镜筛查。1年后,随访依从性急剧下降,因此到术后3年,很少有患者被看到并安排进行干预,如食管胃十二指肠镜检查。本质量改进项目的目的是评估对SG肥胖患者随访依从性的患者教育讲义的有效性。方法:采用准实验设计和回顾性图表法。制作了一份教育讲义。干预前回顾性图表包括441例SG患者,随访12至48个月。干预后包括3个月的讲义干预,数据收集共计198例患者。结果:干预前4年随访依从性为0% /12.2% (P = 0.008),干预前3年随访依从性为13.4% /干预后12% (P = 0.846),干预前2年随访依从性为26.3% /干预后28.6% (P = 0.755),干预前18个月随访依从性为26.3% /干预后32.6% (P = 0.365),干预前12个月随访依从性为54.2% /干预后34.1% (P = 0.011)。结论:在本质量改善项目中,教育讲义对随访依从性无统计学影响。
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The Impact of Educational Handouts on the Compliance Rate for Bariatric Patient Follow-Up Appointments.

Background and objectives: Compliance rates for follow-up appointments are an issue for postoperative sleeve gastrectomy (SG) patients. Without consistent reinforcement and monitoring of patient progress, patients tend to gain the weight back, all of the medical improvements made are lost, and the ability to access patients for potential complications is denied. Patients need much reinforcement during their forever bariatric lifestyle, and the lack of consistent reminders may contribute to follow-up noncompliance and recidivism in SG patients. As time progresses, the follow-up appointment compliance rate decreases. Decreased follow-up can lead to a higher risk for complications such as asymptomatic esophagitis, and current recommendations suggest that esophagogastroduodenoscopy screening should occur 3 years postoperatively. After 1 year, the follow-up compliance decreases dramatically so that by the 3-year postoperative period, very few patients are being seen and scheduled for interventions such as an esophagogastroduodenoscopy. The objective of this quality improvement project was to evaluate the effectiveness of a patient educational handout on SG bariatric patient follow-up visit compliance.

Methods: A quasi-experimental design and retrospective chart review was chosen. An educational handout was developed. Preintervention retrospective chart review consisted of 441 SG patients expecting a follow-up in 12 to 48 months. Postintervention included 3 months of the handout intervention with data collection totaling 198 patients.

Results: Follow-up compliance for 4 year visits noted 0% preintervention/12.2% postintervention (P = .008), for 3 year visits 13.4% preintervention/12% postintervention (P = .846), for 2 year visits 26.3% preintervention/28.6% postintervention (P = .755), for 18 months visits 26.3% preintervention/32.6% postintervention (P = .365), and for 12 months visits 54.2% preintervention/34.1% postintervention (P = .011).

Conclusion: In this quality improvement project, educational handouts did not have a statistical impact on follow-up compliance.

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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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