自媒体管理对变应性鼻炎舌下特异性免疫治疗依从性的影响

Influence on compliance of subcutaneous immunotherapy in patients with allergic rhinitis by We-Media management

目的:探讨变应性鼻炎(AR)舌下特异性免疫治疗过程中自媒体管理对患者依从性的影响。方法:将180例接受舌下特异性免疫治疗的AR患者随机分为自媒体管理组(A组)和电话管理组(B组)各90例。A组建立医患微信和(或)QQ群,并成立由课题组专职医生任组长的自媒体管理小组,制订每个月的健康教育计划,每周向群内发送3次以上舌下特异性免疫治疗的相关知识,及时评估患者报告结果;B组进行现场示范和教育,治疗开始后每3个月电话随访1次并进行相应的教育。统计分析两组在治疗后第1、3、6、9、12个月的脱落情况和脱落原因。结果:治疗1年内,A组脱落率为13.3%(12/90),B组脱落率为32.2%(29/90),两组间差异有统计学意义(χ~2=9.128,P=0.003)。前3个月脱落数占本组总脱落数比例,A组为41.7%(5/12),B组为51.7%(15/29),组间差异无统计学意义(χ~2=0.344,P=0.558)。脱落的首要原因是自认为疗效欠佳,其次是信心不足。结论:自媒体管理有助于提高接受舌下特异性免疫治疗的AR患者的依从性,特别是在患者长期随访中更有优势。

Objective：To investigate the influence on compliance of sublingual immunotherapy（SLIT）in patients with allergic rhinitis by We-Media management.Method：One hundred and eighty patients of allergic rhinitis were randomly divided into We-Media management group（Group A 90 cases）and telephone management group（Group B 90 cases）.All of patients were treated with SLIT.In the group A,the doctor-patient WeChat and/or QQ group were formed.The specific duty doctor acted as group leader,made monthly plans,sent SLIT related knowledge more than 3 times a week and assessed patient reported outcomes.In the group B,the patients were conductd on-the-spot demonstration and explanation and followed up by telephone once three month.The statistical analysises were made on the rates and reason of dropouts on the first,third,sixth,ninth,twelfth post-treatment months in two groups.Result：The rates of dropouts in group A and group B were 13.3%（12/90）and 32.2%（29/90）respectively in the first year.The statistical difference were noticeable between group A and group B（χ~2=9.128,P=0.003）.Most dropouts were happened in the first 3 months,group A 41.7%（5/12）and group B 51.7%（15/29）respectively.It had no statistically significant（χ~2=0.344,P=0.558）.Two major reasons of dropouts were no improvement of symptoms and lack of confidence.Conclusion：Percentage of dropouts in SLIT patients through telephone management was comparatively high,which can be significantly improved by We-Media management.We-Media management has more advantage,especially during long-term follow-up.