Page 13 - 中国全科医学2022-08

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A Real-world Data Study on Comprehensive Control Rates in a Large Population of Type 2 Diabetes Patients HUANG
1*
Jingyuan ，HUANG Yanli 2
1.Community Health Center of Jiangxi Street，Chengdu 610041，China
2.Hospital Management Center of Wuhou District，Chengdu 610041，China
*
Corresponding author：HUANG Yanli，Associate chief physician，Minister of science and information；E-mail：maomaohyl@
qq.com
【Abstract】 Background There are differences between RCTs and real-world data in reporting the rate of clinical
control of patients with diabetes，which cannot solve the problem of continuous observation in large-scale populations. At
present，there is no real-world data cross-sectional survey research and related literature of clinical control indicators of T2DM
patients who avoid direct contact with patients and doctors in China. Objective To explore the clinical control compliance rate
of individual and comprehensive indicators in patients with type 2 diabetes mellitus （T2DM） in the real world. Methods
Since 2017，13 community health service institutions in Wuhou District that have gradually bound the data of the primary care
information business system to the EPM through unique ID information were selected as sample areas. T2DM patients with EPM
bound in the sample area were selected as the research subjects. The effective follow-up period，within 1 year outside the effective
follow-up period，and more than 1 year outside the effective follow-up period of T2DM patients with glycated hemoglobin （HbA 1c ），
low-density lipoprotein cholesterol （LDL-C），blood pressure follow-up rate，average level，and clinical control compliance
rate were recorded. The follow-up rate of comprehensive indicators of 3B （ie HbA 1c ，LDL-C，blood pressure） and the rate
of clinical control compliance were recorded. The correlation between HbA 1c ，LDL-C，blood pressure，3B comprehensive
indicators and the number of T2DM patients managed in different community health service institutions，the correlation between
the number of patients with HbA 1c ，LDL-C，blood pressure and the effect of each indicator during the effective follow-up
period sex were analyzed. Results Among the 26 501 contracted T2DM patients，the follow-up rates of HbA 1c ，LDL-C，
blood pressure and 3B comprehensive indicators during the effective follow-up period were 43.54%（11 539/26 501），45.66%
（12 101/26 501），89.18%（23 633/26 501）and 32.89%（8 715/26 501），respectively. The follow-up rates of HbA 1c ，
LDL-C，blood pressure and 3B composite indicators within 1 year outside the effective follow-up period were 15.81%（4 190
/26 501），24.02 % （6 366/ 26 501），9.29（2 463/26 501）and 0.97%（257/26 501）respectively. The follow-up rates of
HbA 1c ，LDL-C，blood pressure and 3B comprehensive indicators beyond the effective follow-up period for more than 1 year were
19.20%（5 087/26 501），23.41%（6 203/26 501），1.28%（339/26 501）and 0.49%（131/26 501），respectively. During
the effective follow-up period，the clinical control rates of HbA 1c ，LDL-C，blood pressure and 3B comprehensive indicators
were 60.79%（7 015/11 539），59.74%（7 229/12 101），52.57%（12 423/23 633） and 18.75%（1 634/8 715），
respectively. The clinical control rate of HbA 1c ，LDL-C，blood pressure，and 3B comprehensive indicators within 1 year outside
the effective follow-up period were 51.98% （2 178/4 190），56.75%（3 613/6 366），47.79%（1 177/2 463） and 14.79%
（38/257），respectively. The clinical control rates of HbA 1c ，LDL-C and blood pressure beyond the effective follow-up period
for more than 1 year were 65.62%（3 338/5 087），59.46%（3 688/6 203） and 22.71%（77/339），respectively. There was
a high correlation between the blood pressure clinical control compliance rate and the 3B comprehensive index clinical control
compliance rate（r=0.949，P<0.01）. HbA 1c （r=0.648），LDL-C（r=0.867），blood pressure（r=0.988），and the number
of 3B comprehensive indicators（r=0.712） were positively correlated with the number of T2DM patients managed in different
community health service institutions within the validity period（P<0.05）. The mean LDL-C was negatively correlated with the
number of managed cases of T2DM patients（r=-0.715，P<0.01），and the number of clinically controlled cases（r=0.888）
and the rate of clinically controlled compliance（r=0.704） were positively correlated with the number of managed cases of T2DM
patients（P<0.05）. Blood pressure（r=0.791），the number of clinically controlled cases of 3B comprehensive indicators（r=0.616）
were positively correlated with the number of managed cases of T2DM patients（P<0.05）. The standard deviation of HbA 1c
was negatively correlated with the number of HbA 1c follow-up cases within the validity period （r=-0.708，P<0.01），and the
number of clinically controlled cases was positively correlated with the number of HbA 1c follow-up cases within the validity period
（r=0.943，P<0.01）. The average LDL-C value was negatively correlated with the number of LDL-C follow-up cases within
the validity period（r=-0.716，P<0.01），and the number of clinically controlled cases and the clinical control compliance rate
were positively correlated with the number of LDL-C follow-up cases within the validity period（r=0.986，r=0.657，P<0.05）.
There was a positive correlation between the number of blood pressure clinical control patients and the number of blood pressure
follow-up cases within the validity period（r=0.839，P< 0.01）. Conclusion The individual and comprehensive control levels