长期慢病管理对RA患者强化自我管理并保持健康状态的影响

The Effect of Long-term Chronic Disease Management on Strengthening Self-management and Maintaining Health in RA Patients

目的探讨长期慢性病管理对类风湿关节炎(RA)患者在COVID-19流行期间持续自我管理和疾病活动的影响。方法选取2020年3月~4月在绵阳市中心医院免疫科住院及门诊随诊的RA患者442例,根据是否参与慢病管理将其分为慢病管理组(231例)与对照组(211例),比较两组患者疫情前后疾病活动度(DAS-28)评分、疫情期间延续性治疗情况及疫情后基于健康调查量表(SF-36)的心理和生理健康状况。结果慢病管理组DAS-28评分,服用非甾体抗炎药、糖皮质激素以及同时服用三种改善病情抗风湿药的患者均少于对照组,差异有统计学意义(P<0.05);慢病管理组疫情期间减药或停药患者、减药或停药持续时间少于对照组,差异有统计学意义(P<0.05);疫情后慢病管理组维持达标治疗患者、生理健康评分和心理健康评分高于对照组,差异有统计学意义(P<0.05)。结论长期慢病管理可改善RA患者持续用药依从性,强化自我管理,有助于患者有效应对COVID-19疫情,并保持健康状态。

Objective To explore the impact of long-term chronic disease management on the continuous self-management and disease activities of patients with rheumatoid arthritis(RA)during the COVID-19 epidemic.Methods A total of 442 RA patients who were hospitalized and followed up in the Department of Immunology of Mianyang Central Hospital from March to April 2020 were selected.According to whether they participated in chronic disease management,they were divided into chronic disease management group(231 cases)and control group(211 cases).The disease activity(DAS-28)scores before and after the epidemic,the continuous treatment during the epidemic,and the mental and physical health status based on the Health Survey Scale(SF-36)after the epidemic were compared between the two groups of patients.Results The chronic disease management group DAS-28 score,the number of patients taking non-steroidal anti-inflammatory drugs,glucocorticoids,and three anti-rheumatic drugs to improve their condition were less than those of the control group,the difference was statistically significant(P<0.05);In the chronic disease management group,the duration of drug reduction or withdrawal during the epidemic period was less than that of the control group,the difference was statistically significant(P<0.05);After the epidemic,the chronic disease management group maintained up to standard treatment,and the physical health score and mental health score were higher than those of the control group,the difference was statistically significant(P<0.05).Conclusion Long-term chronic disease management can improve the continuous medication compliance of RA patients,strengthen self-management,and help patients effectively cope with the COVID-19 epidemic and maintain a healthy state.