The Effect Evaluation Of Community Based Stratified And Integrative Medical Care On The Subjects With Dyslipidemia

Objective:Explore the management model of community based stratified and integrative medical care on subjects with dyslipidemia,and evaluate the effect of the subjects with dyslipidemia.Methods:In this cohort study,we recruited 2586 participants from a community in Hangzhou.There were 774 subjects showed dyslipidemia in the baseline study,in which 406 subjects had signed the contract,andnother 368 subjects had not,A total of 420 subjects were selected randomly for research from each of that,and they were divided into two groups,220 subjects who signed the contract were included in the intervention group,and the other 200 subjects who didn't sign the contract were included in the control group.General practitioner team signed the contract with the subjects one to one in the intervention group,and the relevant information by the form of questionnaire.The community nurses established the files of health and chronic diseases,and then provided stratified and integrative management for these subjects for 12 months..Firstly,these subjects were treated by general practitioner team,and they will be refered to the chief physician team and adjusted the treatment if their blood lipid level was still higher than normal range after 3 months of treatment by GPs,If the blood lipid level kept in the normal range in 3 months,the chief team refered them to the general practitioner team,otherwise they would refer them to the specialist for better treatment,the general practitioner team also followed up the therapeutic process at the same time.We also established the health files for the subjects in control group and the practitioner team provided the therapy of medication.After 12 months,Related metabolic factors of the subjects with dyslipidemia were analyzed by applying Logistic regression,using statistic software SPSS 19.0.Drug therapy compliance,lifestyle change,TC,LDL-C,TG,HDL-C,FBG and UA in the intervention group,and the ratio of hypercholesterolemia,high triglyceride,high low-density cholesterol,low high-density cholesterol,overweight/obesity,abdominal obesity,hypertension,hyperuricemia,hyperglycemia and so on.The effect of management based on the stratified diagnosis and treatment about the subjects with dyslipidemia are analyzed.Results:After 12 months of management,the intervention group showed the better compliance of medication therapy,and highter rate of medication therapy,compared to control group,which had statistical significance(P<0.05);the life style change in the intervention group was prior to the control group,TC,LDL-C,TG,FBG and UA are decline,while the level of HDL-C was increased,with statistical significance(P<0.05).The proportion of hypercholesterolemia,high triglyceride,high low-density cholesterol,low high-density cholesterol,overweight/obesity,abdominal obesity hypertension,hyperuricemia,hyperglycemia were decreased in the intervention group,with statistical significance(P<0.05),but the rate of high blood sugar between intervention group and control group,without statistical significance(P>0.05).Conclusion:The stratified and integrative management of the subjects with dyslipidemia could improve their medication therapy compliance,medicaiton-taking rate,lifestyle change,and reduce the metabolic abnormalities,Therefore,this service could increase the management effect on the subjects with dyslipidemia.