WONCA研究论文摘要汇编——利用电子健康记录进行干预研究:一项旨在减少基层医疗机构抗生素使用的群组随机对照试验

发布时间：2018-02-28 06:25

本文关键词： 电子健康记录 WONCA 抗生素处方随机对照试验家庭医学呼吸道感染基层医疗机构电子病历临床实践负性事件 　出处：《中国全科医学》2014年33期 　论文类型：期刊论文

【摘要】：目的利用电子健康记录进行医疗点群组随机对照试验。对数字化传递决策支持工具减少初级医疗机构呼吸道感染抗生素使用方面的有效性进行评价。方法此研究包括的家庭医学诊所来自参与临床实践研究数据链的英国和苏格兰诊所。随机将53家家庭医学诊所纳入干预组;51家纳入常规治疗组(对照组)。将年龄18~59岁因呼吸道感染就诊患者纳入研究。患者就诊时,通过远程安装的决策支持工具实施干预。对照组提供常规治疗。根据电子健康记录计算呼吸道感染患者抗生素处方率。将家庭医学诊所抗生素处方率纳入聚类分析。结果 603 409例患者数据分析结果显示:干预组317 717例,对照组285 692例。实施干预比预期要少,各个诊所存在差异。就诊时抗生素处方率下降了1.85%〔95%CI(0.10%,3.59%),P=0.038〕,呼吸道感染抗生素处方率下降了9.69%〔95%CI(0.75%,18.63%),P=0.034〕,未见负性事件发生。结论利用初级保健电子病历可进行大样本群组随机对照试验。将来应开发和测试多样化的方法,以开展远程干预。
[Abstract]:Objective to evaluate the effectiveness of digital delivery decision support tool (DSS) in reducing the use of antibiotics for respiratory tract infections in primary medical institutions. Including family medicine clinics from UK and Scottish clinics involved in clinical practice studies. 53 family medicine clinics were randomly enrolled in the intervention group, 51 in the routine treatment group (control group) and 18 59 years old in respiratory therapy. Patients with tract infection were included in the study. Intervention through remotely installed decision support tools. Control group provides routine treatment. Based on electronic health records, antibiotic prescription rates for patients with respiratory tract infection are calculated. Antibiotic prescription rates in family medical clinics are included in cluster classification. Results the data analysis of 603 409 patients showed that there were 317 717 cases in the intervention group. In the control group, 285,692 cases were treated with less intervention than expected. There were differences among the clinics. The prescription rate of antibiotics decreased by 1.85% to 95% and 3.59% to 3.59%. The prescription rate of antibiotics for respiratory tract infection decreased by 9.6995% and 18.633.34% respectively. No negative events occurred. Conclusion A large sample of electronic medical records can be used for random control of respiratory tract infections. Testing. Methods of diversification should be developed and tested in the future, For remote intervention.
【作者单位】：中国石油天然气集团公司中心医院;
【分类号】：R95

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