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背景保健专业人员向患有相同疾病的患者提供团体医学随访已经成为初级保健随访的方法,由此满足慢性病患者对医疗保健服务日益增多的需求。本研究对糖尿病患者团体医学随访的效果进行系统性回顾及荟萃分析。方法经电子数据库及灰色文献检索,对1947年—2012年2月发表的所有相关文献进行系统性回顾,包括英文版随机对照试验及观察性研究中16~80岁曾接受过团体医学随访的1型或2型糖尿病患者。对这些研究进行方法学质量评估,仅从经过荟萃分析的随机对照试验中提取数据。结果从检出的94篇文献中选择符合入选标准的26篇文献,其中13篇为随机对照试验。对于临床和患者-报告结果,团体医学随访具有积极效果,患者的糖化血红蛋白(HbA1c)明显下降〔降低0.46%,95%CI(0.80%,0.31%)〕。由于研究结果报告中的随机对照试验数量不足,未能对团体医学随访在疗程中所起的作用做出评价。解释糖尿病患者的团体医学随访可有效降低HbA1c。荟萃分析表明,团体医学随访能够对糖尿病患者的恢复起到积极作用。
Background Health professionals provide group medical follow-up to patients with the same disease as primary care follow-ups, thereby meeting the growing demand for health care services for people with chronic diseases. This study systematically reviewed and meta-analyzed the effect of group medical follow-up in diabetic patients. Methods A systematic review of all relevant articles published between 1947 and February 2012, including electronic databases and gray literature searches, was conducted in English-language randomized controlled trials and in observational studies of patients aged 16 to 80 who had undergone group medical follow-up Type or type 2 diabetes patients. Methodological quality evaluations of these studies were performed and data were only extracted from meta-analyzes of randomized controlled trials. Results Twenty-six articles that met the inclusion criteria were selected from the 94 published articles, of which 13 were randomized controlled trials. Group clinical follow-up had a positive effect on clinical and patient-reported outcomes, with a significant decrease in HbA1c (0.46%, 95% CI, 0.80%, 0.31%). The lack of adequate randomized controlled trials in the report of the study failed to assess the role of group medical follow-up in the course of treatment. Interpretation of group medical follow-up in diabetic patients is effective in reducing HbA1c. A meta-analysis showed that group medical follow-up can play a positive role in the recovery of diabetic patients.