斯洛文尼亚家庭医学实践中经常参加的老年人的特点——一项横断面研究

J. Rifel, P. Selič
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引用次数: 3

摘要

引言:经常参加家庭医学实践与老年患者和慢性病患者有关。长期频繁参加的与会者有更多的社会和精神问题、医学上无法解释的疾病和慢性病,并被开了更多的精神药物和止痛药。目的:填补有关老年人频繁参加家庭医疗实践相关因素的数据不足。方法:2017年,40名家庭医生参与了这项横断面研究,并随机招募了多达20名患者;624名患者被招募。从患者的健康记录中,FP收集了人口统计数据、生活方式因素、所有患者的诊断、前12个月内开的所有药物、多发病率(CIRS-G指数)、生活质量指数(EQ-5D)和前12个月中家庭医疗就诊次数。患者采用抑郁自评量表。使用IBM SPSS 20.0软件包进行统计分析,并进行适当的非参数检验(Mann-Whitney U检验、卡方检验),以检查患者组之间的显著差异。进行了多变量建模,以评估FP就诊次数与自变量之间的相关性。结果:处方药的数量(p=0.026)、血液学问题(p=0.005)和泌尿生殖系统问题(p=0.001)与频繁就诊有关。与非抑郁症患者相比,边缘型抑郁症患者成为常客的可能性大约高出三倍。结论:多药治疗、血液学和泌尿生殖系统问题与老年患者的频繁就诊有关。需要进一步的纵向研究来验证我们的发现。
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Characteristics of Elderly Frequent Attendees in Slovene Family Medicine Practices - a Cross-sectional Study
Introduction: Frequent attendance in family medicine practices is associated with elderly patients and those with chronic diseases. Longstanding frequent attendees have more social and psychiatric problems, medically unexplained conditions, and chronic diseases, and are prescribed more psychotropic drugs and analgesics. Aim: To fill the lack of data on the factors associated with frequent attendance at family medicine practices by the elderly. Methods: Forty family physicians (FPs) participated in this cross-sectional study in 2017 and randomly recruited up to 20 of their patients; 624 patients were recruited. From the patients’ health records, the FPs collected demographic data, lifestyle factors, all the patients’ diagnoses, all the drugs prescribed in the previous 12 months, multi-morbidity (CIRS-G index), the quality of life index (EQ-5D) and the number of visits to the family medicine practice in the previous 12 months. The Self-Rating Depression Scale was administered to the patients. Statistical analysis was carried out using the IBM SPSS 20.0 package, with appropriate non-parametric tests (Mann-Whitney U test, chi-square test) to check significant differences between groups of patients. Multivariate modelling was carried out to evaluate the associations between the number of visits to the FP and independent variables. Results: The number of prescribed drugs (p=0.026), haematological problems (p=0.005) and genitourinary problems (p=0.001) were associated with frequent attendance. Patients with borderline depression were approximately three times more likely to be frequent attendees than non-depressed patients. Conclusion: Polypharmacy, haematological and genitourinary problems are associated with frequent attendance in elderly patients. Further longitudinal studies are required to validate our findings.
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