Cochrane综述综述:改善初级保健和社区环境中多病患者预后的干预措施

D. Trivedi
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引用次数: 10

摘要

纳入的研究针对多病人群,多病定义为同一个人有两种或两种以上的慢性疾病。合并症一词指的是通常存在的已定义疾病的组合,例如糖尿病和心脏病。这篇Cochrane综述包含18项随机对照试验(rct),其中9项针对患有多种疾病或多重疾病的人群(Smith et al., 2016)。剩下的9项包括合并症:抑郁症合并高血压、头痛、糖尿病和/或心脏病,还有一项研究是针对至少患有两种糖尿病、慢性阻塞性肺病和肠易激综合征的人进行的。大多数研究评估了干预措施,包括改变护理服务的组织,一些研究提供了更多以患者为中心的干预措施。干预措施在初级保健或社区环境中实施,并与常规护理进行比较。总共有16项研究在美国进行,一项在英国,一项在加拿大。没有专门针对多发病的研究被排除在外。
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Cochrane Review Summary: Interventions for improving outcomes in patients with multimorbidity in primary care and community settings
Included studies targeted people with multimorbidity, defined as two or more chronic conditions in the same person. The term comorbidity referred to combinations of defined conditions that commonly exist, for example, diabetes and heart disease. This Cochrane review contained 18 randomised-controlled trials (RCTs) of which nine targeted people with a broad range of conditions or multimorbidity (Smith et al., 2016). The remaining nine included comorbidities: depression with hypertension, headache, diabetes and/or heart disease and one study with a sub-group of people who had at least two of diabetes, chronic obstructive pulmonary disease and irritable bowel syndrome. Most studies evaluated interventions involving changes to the organisation of care delivery with some studies delivering more patient-focussed interventions. Interventions were delivered in primary care or community settings and compared with usual care. In all, 16 studies were conducted in the United States, one in the United Kingdom and one in Canada. Studies that did not aim to specifically target multimorbidity were excluded.
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