A86 为加拿大ibd患者提供现代护理信息:关于预约类型的前瞻性随机试验

C. Galts, B. Siempelkamp, K. Cade, L. Wilson, D. Loomes
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引用次数: 0

摘要

摘要 背景 目前有大量数据支持将虚拟医疗(远程医疗或电话)作为一种为 IBD 患者提供医疗服务的手段,其效果与面对面的医疗服务相当。许多评估虚拟医疗的研究缺乏对照组,并且存在回忆偏差。此外,还缺乏对患者个人预约方式偏好及其原因的了解。目的 我们旨在确定患者偏好的预约方式,并通过评估人口统计因素和其他预约相关因素(如费用、所需时间、沟通、隐私等)来了解这些偏好。我们假设,这些信息可能有助于为患者选择最佳预约方式提供决策依据。方法 在这项单中心随机试验中,我们按顺序将 IBD 患者分配到面诊、远程医疗(视频)或电话预约。为了尽量减少回忆偏差,我们在每种预约方式之后都填写了调查问卷。我们收集了所有参与者的人口统计学数据,并使用 UBC redcap 对调查数据进行了汇编。标准回归分析和 T 值用于评估统计意义。结果 在排除了数据不完整的调查问卷后,共纳入了 81 份调查问卷,其中包括 27 份面谈问卷、28 份电话问卷和 26 份远程医疗问卷。面谈、电话和远程保健预约的总得分(满分 10 分)分别为 9.1 ±1.0、7.8 ±2.1 和 8.0 ±2.6。如果不包括出现技术故障的远程医疗预约(6 人),总分会有所提高,范围与面对面预约相当(8.9 ±1.2)。面对面预约的费用较高,时间较长,但在所有预约特征(如隐私感、医生参与度等)方面得分最高。在希望进行面对面预约的患者中,最佳沟通(80.0%)和与医疗服务提供者的互动(83.3%)被放在首位。相反,在希望选择远程医疗预约的参与者中,节省时间(71.4%)和节省费用(42.9%)被放在首位。年龄、性别、受抚养人数量和隐私感与预约方式偏好无关。结论 本研究得出结论,所有的预约方式都有一定的优点和缺点,不同的患者可能会优先考虑这些优点和缺点。面对面预约的费用和时间要求较高,但仍然是评价最高的预约方式。由于虚拟医疗将继续成为 IBD 患者标准医疗的一部分,我们建议医疗服务提供者根据患者的情况和预期的就诊性质来选择个性化的预约方式。资助机构 无
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A86 INFORMING MODERN CARE FOR CANADIAN IBD PATIENTS: A PROSPECTIVE RANDOMIZED TRIAL ON APPOINTMENT TYPES
Abstract Background There is now significant data supporting virtual care (telehealth or telephone) as a means to provide care to IBD patients with equivalent outcomes to in-person care. Many studies assessing virtual care lack a control group and suffer from recall bias. Further, there is a lack of understanding individual patient appointment style preferences and the reasons for these preferences. Aims We aimed to determine patient’s preferred appointment styles and to inform these preferences by assessing demographic factors and other appointment related factors (e.g. cost, time required, communication, privacy etc). We hypothesize that this information may help to inform decisions regarding choosing the optimal appointment for patients. Methods In this single centre randomized trial we assigned IBD patients to in-person, telehealth (with video), or telephone appointments in a sequential manner. To minimize recall bias, surveys were completed after each appointment style. All participants had demographic data collected and survey data was compiled using UBC redcap. Standard regression analyses and T-scores were used for assessment of statistical significance. Results After exclusion of surveys with incomplete data, a total of 81 surveys were included, 27 in-person, 28 telephone, and 26 telehealth. The overall scores (out of ten) were 9.1 ±1.0, 7.8 ±2.1, and 8.0 ±2.6 for in-person, telephone and telehealth appointments respectively. With exclusion of telehealth appointments which suffered technical difficulties (n=6) the overall score improved and range was comparable to in-person appointments (8.9 ±1.2). In-person appointments were associated with a higher cost and longer time commitment but had the highest scores across all appointment features (e.g. perceived privacy, physician engagement etc.). Among patients who would have preferred an in-person appointment optimal communication (80.0%) and interaction with care provider (83.3%) were prioritized. Conversely, among participants who would have preferred telehealth appointments, time savings (71.4%) and cost savings (42.9%) were prioritized. Age, gender, number of dependents, and perceived privacy were not associated with any appointment style preference. Conclusions This study concludes that all appointment styles have certain benefits and drawbacks that individual patients may variably prioritize. In-person appointments had a higher cost and time requirement but still remained the highest rated appointment style. As virtual care continues to be part of the standard of care for patients with IBD, we suggest that providers individualize the style of patient appointment to their patients and the expected nature of that encounter. Funding Agencies None
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