Objective The aim of the study is to evaluate the effect of the tuberculosis (TB) patients treatment management by using a "Real-time Monitoring and Early Warning Mode for Patient Treatment" which was established by the Shenzhen Nanshan District Center for Chronic Disease Control in the TB electronic direct observation treatment system and accumulate experience for improving the treatment management of TB patients.Methods The pulmonary TB patients registered in the Shenzhen Nanshan District Center for Chronic Disease Control before the mode was established,from 1st June,2012 to 31st October,2013,were enrolled into this study as the control group and a total of 41 774 times of medication management for those patients were evaluated,while the TB patients registered after the mode was established,from 1st August,2014 to 31st December,2015,were enrolled as the intervention group and with 32 698 times of medication management.Poisson Distribution,Chi-square test and Mann-Whitney U rank sum test were used to compare the missing medication rate of the patients and the delay of the missing medication tracing conducted by the tertiary and primary supervision doctors between the two groups,P＜0.05 was considered as statistically significant.Results The intervention group had the lower persontimes of the missing medication (612) than that happened in the control group (927),and the difference between the two groups was statistically significant (Z=8.02,P＜0.01);the delay rates of the missing medication tracing conducted by the tertiary supervision doctors (9.15％,56/612) and primary supervision doctors (5.23％,32/612) in the intervention group were lower than those in the control group (17.58％,163/927 and 8.09％,75/927 respec tively),and the dif-ferences of both rates between the two groups were statistically significant too (x2 21.48,P＜0.01;x2 =4.67,P=0.03).In the intervention group,the medians of the delayed days of the missing medication tracing conducted by the tertiary and primary supervision doctors were 2 days respectively,while the delayed days in the control group were 1 day and 2 days,respectively,but the differences between the two groups were not statisti cally different (Z=-1.31,P=0.19;Z=-0.02,P=0.98).Conclusion The "Real-time Monitoring and Early Warning Mode for Patient Treatment" can improve the efficiency and quality of the patient's medication management.%目的 评估深圳市南山区采用结核病电子网络督导管理系统中“患者服药实时监控-预警提醒模式”管理患者的效果,为进一步提高患者管理水平积累经验.方法 通过自身前后对照,对比分析深圳市南山区在结核病电子网络督导管理系统中建立“患者服药实时监控-预警提醒模式”前(2012年6月1日至2013年10月31日纳入管理的491例患者为“对照组”,服药管理41 774例次)及建立后(2014年8月1日至2015年12月31日纳入管理的431例患者为“干预组”,服药管理32 698例次)患者漏服药情况及督导医生追踪延迟情况,采用泊松分布、卡方检验和Mann-Whitney U秩和检验对两组资料进行统计学分析,以P＜0.05为差异有统计学意义.结果 干预组漏服药612例次,低于对照组的927例次,差异有统计学意义(Z=8.02,P＜0.01).三级督导点漏服追踪延迟率干预组为9.15％(56/612),低于对照组的17.58％(163/927);一级督导点漏服追踪延迟率干预组为5.23％(32/612),低于对照组的8.09％(75/927),差异均有统计学意义(x2=21.48,P＜0.01;x2=4.67,P=0.03).三级督导点干预组漏服追踪延迟天数中位数为2d,对照组为1d;一级督导点漏服追踪延迟天数中位数干预组为2d,对照组也为2d,差异均无统计学意义(Z=-1.31,P=0.19;Z=-0.02,P=0.98).结论 “患者服药实时监控-预警提醒模式”对服药管理的时效性和工作质量有促进和优化作用.
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