医患共享决策干预对慢性哮喘患者预后效果的系统评价和Meta分析

The Effect of Shared Decision-making Intervention on the Orognosis of Patients with Chronic Asthma:A Systematic Review and Meta-analysis

目的针对医患共享决策干预对慢性哮喘患者预后效果的影响进行系统评价。方法计算机检索Cochrane Librar-y.Pubmed、Embase、Web of Science.中国生物医学文献数据库、中国知网、万方和维普数据库中关于共享决策模式干预在慢性哮喘患者人群中的随机对照研究,对所纳入文献的数据进行Meta分析。结果最终纳人8篇文献,共5253位哮喘患者。共享决策模式干预可改善患者哮喘控制情况(P=0.006),降低其急诊就诊率(P<0.001)和哮喘症状恶化住院率(P=0.03),同时增强患者的服药依从性,但在哮喘患者的预后生活质量得分上无统计学意义(P=0.41)。结论共享决策干预有助于哮喘患者症状控制情况的改善,降低急诊就诊率和症状恶化住院率,提高患者服药依从性。建议未来在临床哮喘领域继续开展相关干预研究,进--步验证其有效性。

Objective To evaluate the effectiveness of shared decision making intervention in improving the prognosis of chronic asthma patients through systematic review.Methods Our team conducted a database scarch to collect the randomized controlled trials studies on shared decision making interventions in patients with chronic asthma among databases,including Cochrane Library,Pubmed,Embase,Web of Science,CMB,CNKI,Wanfang,and VIP.We processed Rev man 5.3 software to analyze the data.Results 8 articles were included finally,with a total of 5253 asthma patients.The analysis results showed that shared decision making intervention can improve the asthma control(P=0.006),reduce the rate of emergency department visits(P<0.001)and the hospitalization rate of worsening asthma symptoms(P=0.03),as well as strengthen patient medica-tion compliance,but showed no statistical significance in score of the quality of life in asthma patients(P=0.41).Conclusions Shared decision making intervention can help improve the asthma symptom control of patients,reduce the rate of emergency department visits and the hospitalization rate,as well as improve patient medication compliance at the same time.The field of chronical asthma needs more studies to verify its efectiveness further.