ObjectiveTo verify the reliability of Anticlot Assistant, a patient self-management system for warfarin therapy assisted by artificial intelligence.MethodsIt was a single-center, prospective cohort study. The eligible 34 participants were recruited consecutively between November 29, 2017 to September 27, 2018 and managed by warfarin therapy via Anticlot Assistant. The recommendations of Anticlot Assistant were examined and verified by the doctors to ensure the security. Medical records were exported from the the background management system. An univariate analysis compared the outcomes between accepted and overridden records and a logistic regression model was built to determine independent predictors of the outcomes. The research team analyzed 153 medical records, which were from 18 participants and were input by 19 doctors. There were 97 records with doctor accepting the suggestion and 56 records with doctor rejecting the suggestion .ResultsWhen the doctors accepted the recommendations, the percentage of the next-test international normalized ratio (INR) in the therapeutic range was higher (64.95% vs. 44.64%, RR=2.298, 95%CI 1.173 to 4.499, P=0.014). The logistic regression analysis revealed that accepting the recommendations was an independent predictor for the next-test INR being in the therapeutic range after controlling potentially confounding factors (OR=2.446, 95%CI 1.103 to 5.423, P=0.028).ConclusionThe algorithm of Anticlot Assistant is reasonable and reliable.
Objective To explore the current situation and influencing factors of self-management behavior in patients with primary glaucoma, so as to provide a theoretical basis for formulating intervention strategies to improve patients’ self-management ability. Methods Using convenient sampling method, 400 patients with primary glaucoma visiting the Outpatient Department of Ophthalmology, West China Hospital of Sichuan University between September 2019 and March 2020 were selected. Their current situation of self-management behavior was investigated by self-management behavior questionnaire, and the influencing factors of self-management behavior were analyzed. Results A total of 381 valid questionnaires were recovered. The total score of self-management behavior of patients with primary glaucoma was 51.11±6.22, and the mean scores of life debugging dimension, functional health care dimension, and medical management dimension were 2.66±0.67, 3.02±0.81, and 3.13±0.60, respectively. The results of multiple linear regression analysis showed that age [40-59 vs. <40 years old: unstandardized partial regression coefficient (b)=–2.830, 95% confidence interval (CI) (–4.813, –0.847), P=0.005; ≥60 vs. <40 years old: b=–2.660, 95%CI (–4.820, –0.498), P=0.016], occupation [in-service vs. farmers: b=2.639, 95%CI (0.303, 4.976), P=0.027; unemployed or retired vs. farmers: b=2.913, 95%CI (0.995, 4.831), P=0.003], smoking [smoking vs. non-smoking: b=–3.135, 95%CI (–5.196, –1.075), P=0.003], disease type [primary open-angle glaucoma vs. primary angle-closure glaucoma: b=–2.119, 95%CI (–3.317, –0.921), P=0.001], number of follow-up visits [≤2 vs. >2: b=–1.071, 95%CI (–2.118, –0.024), P=0.045], whether fixed doctor follow-up [unfixed vs. fixed: b=–2.619, 95%CI (–3.632, –1.605), P<0.001] were correlated with the total score of self-management behavior of patients with primary glaucoma. Conclusions The self-management behavior of patients with primary glaucoma is in the middle level. The main factors affecting the self-management behavior level of primary glaucoma patients include age, occupation, smoking, disease type, follow-up times, and fixed doctor’s follow-up. Ophthalmologists should pay attention to the current situation and influencing factors of self-management behavior and take feasible intervention measures to improve the self-management behavior of patients with primary glaucoma.
Objective To observe the effectiveness of IMPACT management mode on self-care and management abilities of breast cancer patients undergoing chemotherapy with implantable venous access port (VAP). Methods Breast cancer patients who underwent chemotherapy with VAP at Shangjin Hospital, West China Hospital, Sichuan University between March 2020 and June 2021 were prospectively included. IMPACT mode was used for self-management training guidance. The patient self-care abilities before training and at 1 month, 2 months, and 3 months of training were compared, and the patient self-management abilities at 1 month and 3 months of training were compared. Results A total of 74 patients with breast cancer undergoing chemotherapy with VAP were included. The total score of self-care ability of patients before training and at 1 month, 2 months, and 3 months of training was 112.11±14.63, 123.20±15.73, 127.95±13.89, and 131.92±13.60, respectively, and all the between-time-point differences were statistically significant (P<0.05). In terms of self-concept score, all the between-time-point differences were statistically significant (P<0.05) with increasing score over time, except the difference between the score at 3 months of training and that at 2 months of training (P>0.05). In terms of self-responsibility and self-care skill scores, all the between-time-point differences were statistically significant (P<0.05) with increasing scores over time, except the difference between the score at 2 months of training and that at 1 month of training (P>0.05). In terms of health knowledge level, the scores at 1 month, 2 months, and 3 months of training were higher than that before training (P<0.05), and the score at 3 months of training was higher than that at 1 month of training (P<0.05). The self-management ability scores in all dimensions at 3 months of training were higher than those at 1 month of training, and the differences were statistically significant (P<0.05). Conclusion The IMPACT management mode can effectively improve the self-care and management abilities of breast cancer patients undergoing chemotherapy with VAP, thereby ensuring the normal use of VAP, reducing the occurrence of complications, and reducing the burden on families and society.