Quality lines

D. Stevens
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Abstract

Adverse events between visits for patients with diabetes mellitus Adverse events between ambulatory patient visits are increasingly the focus of study. By means of an automated telephone self-management tool, 111 patients with diabetes mellitus were monitored for adverse events between visits in the course of their home management. Of note, the study population was ethnically and linguistically diverse, and most had longstanding and poorly controlled diabetes. Among these patients, 86% had at least one event detected over a 9-month study period totalling 111 adverse events and an additional 153 potential adverse events. Medication management was implicated as the dominant adverse event and constituted 63% of events. Of note inadequate clinician-patient communication was implicated in 59%. In fully 80% of all events, a combination of system, clinician and patient factors contributed to the adverse event. The authors suggest that patient-level self-management support and patient-centred communication offer the greatest opportunities for prevention of adverse events in this setting. See page 223
质量行
糖尿病患者门诊间不良事件日益成为研究的热点。采用自动电话自我管理工具,对111例糖尿病患者在家庭管理过程中随访期间的不良事件进行监测。值得注意的是,研究人群在种族和语言上是多样化的,而且大多数人长期患有糖尿病,控制不佳。在这些患者中,86%的患者在9个月的研究期间至少检测到一次不良事件,总共有111例不良事件和153例潜在不良事件。药物管理是主要的不良事件,占事件的63%。值得注意的是,59%的患者与临床沟通不足。在80%的不良事件中,系统、临床医生和患者因素共同导致了不良事件。作者建议,在这种情况下,患者层面的自我管理支持和以患者为中心的沟通为预防不良事件提供了最大的机会。见第223页
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