Original Article
A preliminary study on the management pathway of atherosclerotic cardiovascular diseases in primary care based on clinical pathway theories
Rongrong Wan, Kai Yu, Shuang Wang, Lu Zhang, Shuguang He, Xin Zhao, Huan Xiao, Xue Lin, Xuejun Liu, Xiaosong Yu
Published 2017-02-04
Cite as Chin J Gen Pract, 2017, 16(2): 100-105. DOI: 10.3760/cma.j.issn.1671-7368.2017.02.003
Abstract
ObjectiveTo evaluate the feasibility and effectiveness of the management pathway of atherosclerotic cardiovascular disease (ASCVD) .
MethodsOne hundred and twenty two elderly patients with more than one ASCVD risk factors contracting general practice service in Changbai Community Health Center of Shenyang Municipality were enrolled. The management pathway of ASCVD was conducted with a integrated intervention model based on the self-control study design. The effects were evaluated with Hibbard′s Patient Activation Measure (PAM) after 6 months of intervention.
ResultsAfter 6 months, 9 participants dropped out of study (7.4%). The questionnaire survey was conducted in 113 participants and the response rate was 100%. After intervention, the overall level of activation in participants was increased(t=5.809, P<0.05). The scores of four stages of activation were increased: believing the importance of active role(t=4.546, P<0.05), confidence and knowledge of taking action (t=4.684, P<0.05), taking action(t=5.332, P<0.05), staying the course under stress (t=7.785, P<0.05). The total scores (t=2.086, P<0.05) and the scores of mental component summary (t=1.980, P<0.05), physical function (t=2.420, P<0.05), vitality (t=3.077, P<0.05), mental health (t=2.992, P<0.05) in SF-36 were increased. The activation of patients was significantly correlated with the quality of life (r=0.320, P<0.05). After intervention, the blood pressure, HbA1c, blood lipid levels trended to be decreased, and the diastolic blood pressure was significantly decreased after intervention (t=2.015, P<0.05).
ConclusionThe ASCVD management pathway and"integrated intervention" model in primary care is feasible and effective. After the implementation, the activation of patients is increased, the quality of life and clinical outcomes are improved in different degrees.
Key words:
Disease management; Clinical pathway; Atherosclerotic cardiovascular diseases
Contributor Information
Rongrong Wan
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Kai Yu
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Shuang Wang
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Lu Zhang
Changbai Community Health Service Center, Heping District, Shenyang 110166, China
Shuguang He
Changbai Community Health Service Center, Heping District, Shenyang 110166, China
Xin Zhao
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Huan Xiao
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Xue Lin
Changbai Community Health Service Center, Heping District, Shenyang 110166, China
Xuejun Liu
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
Xiaosong Yu
Department of General Practice, the First Hospital of China Medical University, Shenyang 110001, China
