CAJ | 학술논문

目的试点改革血脂检查报告单的报告方式,并评价此项改革对相关科室医生调脂治疗知识和行为的影响.方法采取自身前后对照的实验研究,以问卷调查形式,在报告单改革前后对中日友好医院调脂治疗相关科室医生(143人)进行普查,闭卷考核其对指南相关知识的掌握程度,同时了解医生对报告单有用性的评价.对相应的门诊患者进行抽样调查,了解医生处方率变化情况.结果报告单改革后,医务人员对《中国成人血脂异常防治指南》(简称指南)的认知率从67.1％(96/143)提高到83.9％ (120/143) (P＜0.001),指南知识相关题目回答正确均值从9.62±3.29提高到12.88 ±3.79 (P＜0.001).改革前后均参与评价指南有用性的77名医生中,认为指南对工作有很大帮助的医生从55.8％(43/77)上升到75.3％ (58/77)(P=0.005).95.5％的医生认为改革后的报告单优于改革前.但报告单改革前后调脂治疗药物处方率变化差异无统计学意义(63.2％比69.2％,P=0.117).结论血脂检验报告单的改革,提高了医生对指南的认知和掌握程度,但医生总体处方率无明显变化.应尝试将这项改革推广,以期进一步提高临床调脂治疗达标率.
목적 시점개혁혈지검사보고단적보고방식,병평개차항개혁대상관과실의생조지치료지식화행위적영향.방법 채취자신전후대조적실험연구,이문권조사형식,재보고단개혁전후대중일우호의원조지치료상관과실의생(143인)진행보사,폐권고핵기대지남상관지식적장악정도,동시료해의생대보고단유용성적평개.대상응적문진환자진행추양조사,료해의생처방솔변화정황.결과 보고단개혁후,의무인원대《중국성인혈지이상방치지남》(간칭지남)적인지솔종67.1％(96/143)제고도83.9％ (120/143) (P＜0.001),지남지식상관제목회답정학균치종9.62±3.29제고도12.88 ±3.79 (P＜0.001).개혁전후균삼여평개지남유용성적77명의생중,인위지남대공작유흔대방조적의생종55.8％(43/77)상승도75.3％ (58/77)(P=0.005).95.5％적의생인위개혁후적보고단우우개혁전.단보고단개혁전후조지치료약물처방솔변화차이무통계학의의(63.2％비69.2％,P=0.117).결론 혈지검험보고단적개혁,제고료의생대지남적인지화장악정도,단의생총체처방솔무명현변화.응상시장저항개혁추엄,이기진일보제고림상조지치료체표솔.
Objective To compare the physicians' lipid lowering drug prescribing behavior and knowledge on dyslipidemia before and at 8 months after new-issued blood-lipid reports in our hospital.Method Blood-lipid reports in our hospital is newly modified in that the classification of dyslipidemia and lipid-lowering guideline and target lipid level are listed on the back of lipid report besides the normal lipid value listed immediately after the measured lipid levels. Physicians' lipid lowering drug prescribing behavior and knowledge on dyslipidemia before and at 8 months after new-issued blood-lipid reports were examined in 143 doctors from various departments before and at 8 months after new-issued lipid reports.Results At 8 months after the new issued lipid reports,doctors' cognition rate about the guideline was significantly increased [ 83.9％ ( 120/143 ) vs.67.1％ (96/143),P ＜ 0.001 ] and the guideline was considered more helpful on daily practice [75.3％ (58/77) vs.55.8％ (43/77),P =0.005] compared to baseline.However,the prescription rate of dyslipidemia therapy did not change significantly (69.2％ vs.63.2％,P =0.117) at 8 months after the new issued lipid reports.Conclusions The modification of the blood-lipid reports improved doctors' knowledge on dyslipidemia and on the "Chinese guidelines on prevention and treatment of dyslipidemia in adults".However,the lipid lowering drug prescribing behavior remained unchanged at 8 months after the modification of the lipid reports.Further investigation is warranted to see if the lipid lowering drug prescribing behavior could be changed in the long-term.