强化慢病管理门诊对冠心病患者预后的影响

目的:评估强化慢病管理门诊对冠心病患者的服药依从性,心血管事件再入院率,心功能评级的影响。方法:2012年1月2013年12月在成都医学院第一附属医院心血管内科就诊的180例明确诊断冠心病的患者,分为强化管理组和一般管理组(对照组)。强化管理组每2周通过规范化慢病管理门诊方式随访,每3个月定期检测,一般管理组通过每月门诊或电话随访。观察两组患者服药依从性、心血管事件再入院率,心功能评级(NYHA评级)。结果:随访2年后发现,强化管理组阿斯匹林/氯吡格雷(74%vs.54%,P<0.01)、他汀类药物(69%vs.46%,P<0.01)、ACEI/ARB(76%vs.46%,P<0.01)和β受体阻滞剂(63%vs.42%,P<0.05)的服药率均优于一般管理组;因心血管事件再入院率也较低(26%vs.42%,P<0.05)。结论:加强对冠心病患者的规范化管理,有助于提高患者服药依从性,减少患者心血管事件再入院率。

Effect of standardized chronic disease management in patients with coronary heart disease

AIM: To evaluate the efficacy of standardized chronic disease management in outpatients with coronary heart disease in terms of drug compliance,cardiovascular events,readmission rate and rating of cardiac function. METHODS: One hundred and eighty patients with coronary heart disease were divided into standardized chronic disease management group and control group. The standardized chronic disease management group was followed up regularly and regular examination was conducted every 3 months,whereas the control group was followed up by telephone or clinic visit every month. Drug compliance,cardiovascular readmission rate,and heart function grading( NYHA grading) were observed. RESULTS: A2-year follow-up showed that the percentage of taking aspirin and clopidogrel( 74 vs. 54%,P < 0. 01),statins( 69 vs. 46%,P <0. 01),ACEI/ARB( 76 vs. 46%,P <0. 01) and beta blockers( 42 vs. 63%,P <0. 05) in standardized chronic disease management group were higher than those in the control group. Readmission rate of cardiovascular events in standardized chronic disease management group was also lower( 26 vs. 42%,P <0. 05) and the cardiac function class was better than those in control group. CONCLUSION: Standardized chronic disease management for patients with coronary heart disease improves drug compliance and reduces cardiovascular readmission rate.