摘要
目的探讨在房颤患者中进行疾病管理对其抗凝治疗的依从性及治疗效果的影响。方法项目从2009年1月开始，以2009年l-4月住院采取抗凝治疗的110例房颤患者作为疾病管理组。疾病管理方法包括住院期间医生或护士进行常规抗凝治疗教育，提供健康教育手册。出院后每月1次电话随访，指导药物剂量的调整并进行监测。对照组为2008年6-12月住院采取抗凝治疗的房颤患者，仅在住院期间接受医生或护士的常规教育。出院1年时了解两组患者抗凝治疗的情况。结果两组患者性别、年龄、房颤病程和脑卒中高危患者的构成差异无统计学意义。出院1年时疾病管理组抗凝治疗的依从率为85．5％，对照组为53．1％，差异有统计学意义（X^2=30．43，P〈0．001）；疾病管理组监测的依从性显著高于对照组（81.8％US．65．9％，P=0．014）；疾病管理组抗凝治疗的达标率（INR：2．0～3．0）高于对照组（65．9％,US．43．5％，P=0．002）；疾病管理组抗凝治疗相关知识知晓率均高于对照组（P〈0．05）；接受疾病管理的患者对疾病管理的总体满意度达93．6％，电话随访指导方式的满意度达91．8％。结论在房颤患者中进行疾病管理可显著提高抗凝治疗相关知识的知晓率、抗凝治疗和监测的依从性及治疗的达标率，电话随访是患者满意的疾病管理方式。
Objective To assess the long-term compliance on oral anticoagulant therapy in patient with atrial fibrillation （AF）. Methods This was a disease management program which started in January 2009. A total of 110 AF inpatients on warfarin treatment enrolled in disease management group from 1 January 2009 to 30 April. Disease management strategies included pamphlet education, warfarin dose changing and INR monitor by call at least once a month and a mobile for patient inquiring besides concise education from doctor or nurse. 160 AF inpatients prescribed warfarin treatment enrolled in control group from 1 June 2008 to 30 December. All the patients received the concise education by doctor or nurse only. Results Proportion of sex, age, duration of AF and high risk cases for stroke was no significant difference between the two groups. 94 of the 110 patients （85.5%） who kept on taking warfarin in disease management group, whereas this number was 85 for the 160 patients （53.1%） in control group, the difference was significant （X^2=30.48,P〈0.001）.The compliance of INR monitor was significantly higher in disease management （81.8%） than in control group （65.9%） （P=0.014）. The proportion of INR value at 2.0-3.0 was significantly higher in disease management （65.9%） than in the control group （43.5%） （P=0.002）. The awareness of knowledge about anticoagulation treatment in disease management was significantly higher than that in control group. The general satisfactory degree was 93.6% and the satisfactory degree of management by call was 91.8% in patients received disease management. Conclusion The compliance of antieoagulation treatment and the awareness of the knowledge about anticoagulation treatment can be increased significantly by the method of disease management. It is a good way to carry out disease management by call for patients.
出处
《中国慢性病预防与控制》
CAS
北大核心
2011年第3期246-248,共3页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
北京市优秀人才培养资助项目(20081D0300600078)
关键词
房颤
抗凝治疗
疾病管理
依从性
Artial fibrillation
Anticoagulation therapy
Disease management
Compliance
