家庭医生责任制签约服务对社区2型糖尿病患者干预的效果评价

Evaluation of the Effect of Family Doctor Responsibility Contract Service on Community Type 2 Diabetes Mellitus Intervention

目的研究家庭医生责任制签约服务对社区2型糖尿病患者的效果。方法选取在上海市浦东新区惠南社区卫生服务中心进行治疗管理的2型糖尿病患者284例,按随机数字表法分为对照组和实验组,每组各142例。对照组进行药物治疗和基本健康教育,实验组由签约的家庭医生服务团队在采取对照组措施的基础上对2型糖尿病患者进行干预,开展家庭医生责任制签约服务。干预3个月后,比较两组患者干预前后的血糖等指标的变化情况。结果两组治疗后BMI、FBG、2hBG、 HbA1c、TC、TG和LDL-C均比治疗前下降明显,HDL-C比治疗前明显升高,且实验组优于对照组(P<0.05);实验组服药依从性及生活方式改善情况与对照组比较,差异有统计学意义(P<0.05)。结论家庭医生责任制的签约服务可有效改变患者的遵医行为,提高服药依从性,提高患者的生活质量,从而提高糖尿病治疗的效果,值得在社区中推广应用。

OBJECTIVE To study the effect of contract service of family doctor on community type 2 diabetes mellitus.METHODS 284 patients with type 2 diabetes were treated with Huinan Community Health Service Center.The random number table was divided into control group and experimental group.There were 142 cases in each group.The control group was carried out drug treatment and basic health education,the experimental group by the contracted family doctor service team was put out intervene in type 2 diabetes patients,and carry out family doctor responsibility contract service on the basis of the control group of measures.After 3 months of intervention,the changes of blood glucose and other indicators were compared between the two groups before and after intervention.RESULTS After treatment,the levels of BMI,FBG,2hBG,HbA1c,TC,TG and LDL-C were significantly higher than those before treatment(P<0.05),and the HDL-C was significantly higher than that before treatment(P<0.05),and the experimental group was superior to the control group(P<0.05).Compared with the control group,the adherence and lifestyle improvement of the experimental group were statistically significant(P<0.05).CONCLUSIONS The contract service of family doctor responsibility system could effectively change the compliance behavior of patients,improve drug compliance,improve the quality of life of patients,so as to improve the effectiveness of diabetes treatment,which was worth to promote the application in the community.