| Objective: To study the effect of case management mode based on mobile medical APP on intervention of patients with gout.Methods: From May 2020 to September 2020,100 patients with primary gout who were admitted to the rheumatology immunology department of a grade III A hospital in Liuzhou City and met the inclusion criteria were selected as the study subjects,and the study subjects were randomly divided into gout intervention group and gout control group according to the principle of random numerical table distribution.The gout control group was treated with routine gout nursing.The gout intervention group intervened on the basis of routine care using a case management model based on mobile medical APP.Patients in the two groups started intervention after enrollment and continued intervention after discharge.The intervention study lasted for 24 weeks.The case management model based on mobile medical APP adopts a periodic five-step plan,implementation,evaluation,feedback,and through mobile medical APP,establishes one-on-one communication mechanism and education with each patient and family member,and implements the concept of knowledge and trust.Gout information was sent to the gout intervention group on a weekly basis and patients were asked to read the content points to ensure that they read and understood correctly.The family members living with the patient were invited to help supervise the patient’s diet and medication,and the family members were asked about the patient’s implementation on a monthly basis.The patient was informed of the time of each visit in advance,and the blood uric acid level,the number of acute gout attacks,and the time to acute attack remission were recorded.The gout control group was treated with the usual care model,with monthly follow-up visits by phone.The blood uric acid value,the number of acute attacks of gout and the time of remission of acute attack,and the number of times of hospitalization for acute gout attack were recorded.The Morisky medication compliance of patients in both groups were recorded after 12 and 24 weeks of intervention.Psychological anxiety and quality of life(SF-36)scores were evaluated 24 weeks after intervention in 2 groups.To evaluate the gout diet information scale of the two groups for 16 weeks,20 weeks and 24 weeks.Results:1.In this study,100 gout patients were included.Gender,age,course of disease,region,culture,occupation,economic status,marital status,type of medical insurance,number of acute gout attacks in the past year,blood uric acid value,history of alcoholism,BMI、complications were not statistically significant.2.The rate of serum uric acid reaching the standard of 12 weeks and 24 weeks of gout patients in the intervention group was higher than that in the control group.3.During 24 weeks of intervention,the number of acute attacks,remission time of acute attacks in gout intervention group and gout control group were statistically significant(P<0.05).4.After 24 weeks of intervention,the hospitalization rate of patients in gout intervention group was lower than that in control group(P<0.05).5.The scores of drug compliance(Morisky)in gout intervention group at 12 and 24 weeks were higher than those in control group(P<0.05).6.The total score and dimension scores of Gout diet questionnaire were higher than those of the control group for 16 weeks,20 weeks and 24 weeks.The time effect and intervention effect had an interactive effect.The comparison between the two groups was statistically significant(P<0.05).Conclusion1.The case management model based on mobile medical APP can improve the clinical indicators and quality of life of gout patients.2.The case management mode based on mobile medical APP can improve the diet knowledge,belief and practice level of patients with gout.3.The case management model based on mobile medical APP can be popularized and applied in gout management. |
PDF Full Text Request