临床血脂检验报告单改革对相关科室医生调脂治疗知识和行为的影响效果评价  

Short-term impact of modified blood-lipid reports on physicians＇ lipid lowering drug prescribing behavior and knowledge improvement on dyslipidemia

作　　者：李佳慧[1] 姜红[1] 孙星河[2] 李坤砷 柯元南[1] 鄢盛恺[4] 武阳丰 

机构地区：[1]卫生部中日友好医院心内科,北京100029 [2]北京大学医学部公共卫生院流行病与卫生统计学系 [3]中国乔治健康研究所 [4]卫生部中日友好医院检验科,北京100029

出　　处：《中华心血管病杂志》2012年第4期318-322,共5页Chinese Journal of Cardiology

摘　　要：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。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.

关 键 词：血脂异常 诊断 指南 药物疗法 

分 类 号：R446.1[医药卫生—诊断学]