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首页> 外文期刊>Patient Preference and Adherence >De-Intensification Of Blood Glucose Lowering Medication In People Identified As Being Over-Treated: A Mixed Methods Study
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De-Intensification Of Blood Glucose Lowering Medication In People Identified As Being Over-Treated: A Mixed Methods Study

机译：鉴定为过度治疗者的血糖降低强度降低药物：混合方法研究

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Aim: To evaluate if, one year after notification of possible overtreatment, diabetes care providers de-intensified glucose-lowering medications and to gain insight into the opinions and beliefs of both care providers and patients regarding de-intensification. Methods: Mixed methods using routine care data from five health-care centres in the Netherlands. Patient characteristics and medication prescription of patients, previously identified as possibly over-treated, were extracted from patients’ medical records. Opinions of care providers were obtained through interviews. Patients received questionnaires about their diabetes treatment and were asked to participate in focus groups. Results: A total of 64 elderly patients with type 2 diabetes were previously identified as possibly over-treated and included; 57.8% male, median age 75 years (IQR=72–82), median diabetes duration 12 years (IQR=8–18). De-intensification was implemented in more than half (n=36) of them. Care providers preferred person-centred care above just setting general HbA1c target values, considering patient characteristics (such as comorbidity) and patient’s preference. Patients valued glucose levels as most important in determining their treatment. Both patients and care providers felt that de-intensification should occur gradually. Conclusion: Treatment had been de-intensified in more than half of the patients (56.3%). Insight in reasons for not de-intensifying elderly patients is important since treatment for them can be “person-centred care”. De-intensification is an iterative and time-intensive process.
机译：目的：评估在可能过度治疗的通知后一年，糖尿病护理提供者是否对降低血糖的药物进行了强化治疗，并获得了对护理提供者和患者有关强化治疗的观点和信念的见解。方法：使用来自荷兰五个医疗中心的常规护理数据的混合方法。从患者的病历中提取先前被确定为可能被过度治疗的患者特征和用药处方。通过访谈获得护理人员的意见。患者收到有关其糖尿病治疗的调查表，并被要求参加焦点小组。结果：先前确定了总共64名2型糖尿病老年患者，可能被过度治疗并纳入研究。男性57.8％，中位年龄75岁（IQR = 72–82），中位糖尿病病程12年（IQR = 8–18）。其中一半以上（n = 36）实施了去集约化。考虑到患者特征（例如合并症）和患者的偏爱，护理提供者更喜欢以人为本的护理，而不只是设置一般的HbA1c目标值。患者认为葡萄糖水平是决定治疗的最重要因素。患者和医护人员都认为，应逐渐减轻强度。结论：超过一半的患者（56.3％）不再接受强化治疗。重要的是要了解不减轻老年患者的压力的重要性，因为对他们的治疗可以是“以人为本的护理”。取消集约化是一个反复且耗时的过程。

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