Abstract
Objective To evaluate the feasibility and effectiveness of the management pathway of atherosclerotic cardiovascular disease (ASCVD) . Methods One hundred and twenty two elderly patients with more than one ASCVD risk factors contracting general practice service in Changbai Community Health Center of Shenyang Municipality were enrolled. The management pathway of ASCVD was conducted with a integrated model based on the self-control study design. The effects were evaluated with Hibbard′s Patient Activation Measure (PAM) after 6 months of intervention. Results After 6 months, 9 participants dropped out of study (7.4%). The questionnaire survey was conducted in 113 participants and the response rate was 100%. After intervention, the overall level of activation in participants was increased(t=5.809, P<0.05). The scores of four stages of activation were increased: believing the importance of active role(t=4.546, P<0.05), confidence and knowledge of taking action (t=4.684, P<0.05), taking action(t=5.332, P<0.05), staying the course under stress (t=7.785, P<0.05). The total scores (t=2.086, P<0.05) and the scores of mental component summary (t=1.980, P<0.05), physical function (t=2.420, P<0.05), vitality (t=3.077, P<0.05), mental health (t=2.992, P<0.05) in SF-36 were increased. The activation of patients was significantly correlated with the quality of life (r=0.320, P<0.05). After intervention, the blood pressure, HbA1c, blood lipid levels trended to be decreased, and the diastolic blood pressure was significantly decreased after (t=2.015, P<0.05). Conclusion The ASCVD management pathway andintegrated intervention model in primary care is feasible and effective. After the implementation, the activation of patients is increased, the quality of life and clinical outcomes are improved in different degrees. Key words: Disease management; Clinical pathway; Atherosclerotic cardiovascular diseases
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