Clinical practice and effect evaluation of stroke case management model

doi:10.11817/j.issn.1673-9248.2021.06.005

Abstract

Abstract:

Objective

To discuss the clinical practice of stroke case management model and evaluate its interventional effect.

Methods

From July 2018 to June 2019, 100 patients with cerebral infarction were randomly divided into the interventional group and the control group at Beijing Tsinghua Changgung Hospital, Affiliated to Tsinghua University, with 50 cases in each group. The control group received routine medical care management, and the interventional group were given routine care plus case management. The follow-up rates at 1, 6 months after discharge, medication compliance and blood pressure control compliance rate were compared between the two groups.

Results

The follow-up rate at the 1 and 6 months after discharge was 84% and 64% in interventional group verses 64% and 42% in the control group, showing the number of the interventional group was significantly higher than that of the control group (χ²= 5.828, P=0.016; χ²=4.857, P=0.028, respectively). The medication compliance of antiplatelet and statins in the interventional group was 94% and 94% verses 72% and 72% in control group (χ²=8.58, P=0.003; χ²=8.58, P=0.003,respectively). The percentage of patients with controlled blood pressure was 86.2% in the interventional group verses 58.1% in control group (χ²=5.844, P=0.016).

Conclusion

Stroke case management model can effectively improve the compliance of stroke patients with timely follow-up, medication compliance, and blood pressure management. Stroke case management model is an effective medical care model.

Key words: Stroke, Case management model, Clinical practice, Effect

Duoduo Hou, Caihong Li, Yinyin Lyu, Jian Wu. Clinical practice and effect evaluation of stroke case management model[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2021, 15(06): 382-385.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2021.06.005

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2021/V15/I06/382

Figures/Tables 3

组别	例数	男性[例（%）]	年龄（岁， $x ¯$ ±s）	合并高血压[例（%）]	合并糖尿病[例（%）]	合并高脂血症[例（%）]
试验组	50	38（76）	55.74±10.74	29（58）	17（34）	13（26）
对照组	50	39（78）	59.12±11.00	31（62）	18（36）	12（24）
统计值		χ²=0.056	t=-1.554	χ²=0.167	χ²=0.044	χ²=0.053
P值		0.812	0.123	0.683	0.834	0.817

组别	例数	男性[例（%）]	年龄（岁， $x ¯$ ±s）	合并高血压[例（%）]	合并糖尿病[例（%）]	合并高脂血症[例（%）]
试验组	50	38（76）	55.74±10.74	29（58）	17（34）	13（26）
对照组	50	39（78）	59.12±11.00	31（62）	18（36）	12（24）
统计值		χ²=0.056	t=-1.554	χ²=0.167	χ²=0.044	χ²=0.053
P值		0.812	0.123	0.683	0.834	0.817

组别	例数	复诊率		用药依从性		复发率
组别	例数	1个月	6个月	抗血小板药物	他汀类药物	复发率
对照组	50	34（68）	21（42）	36（72）	36（72）	8（16）
试验组	50	44（88）	32（64）	47（94）	47（94）	4（8）
χ²值		5.828	4.857	8.580	8.580	0.852
P值		0.016	0.028	0.003	0.003	0.356

组别	例数	收缩压（mmHg， $x ¯$ ±s）		舒张压（mmHg， $x ¯$ ±s）		达标率[例（%）]
组别	例数	干预前	干预后	干预前	干预后	达标率[例（%）]
对照组	31	153.58±21.42	137.97±9.09	85.77±13.42	83.81±6.18	18（58.1）
试验组	29	147.41±18.11	130.62±12.08	83.62±12.18	77.38±7.55	25（86.2）
统计值		t=-1.200	t=-2.673	t=-0.649	t=-3.62	χ²=5.844
P值		0.235	0.010	0.519	0.001	0.016

组别	例数	收缩压（mmHg， $x ¯$ ±s）		舒张压（mmHg， $x ¯$ ±s）		达标率[例（%）]
组别	例数	干预前	干预后	干预前	干预后	达标率[例（%）]
对照组	31	153.58±21.42	137.97±9.09	85.77±13.42	83.81±6.18	18（58.1）
试验组	29	147.41±18.11	130.62±12.08	83.62±12.18	77.38±7.55	25（86.2）
统计值		t=-1.200	t=-2.673	t=-0.649	t=-3.62	χ²=5.844
P值		0.235	0.010	0.519	0.001	0.016

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