Application And Evaluation Of General Practitioners Centered Multidisciplinary Team Management Model In Patients With ASCVD

Objective:Atherosclerotic cardiovascular disease(ASCVD),which mainly involves ischemic stroke and heart disease,is the leading cause of death in countries around the world.The Report on Cardiovascular Health and Diseases in China 2020 shows that cardiovascular diseases in China are still in the stage of rapid growth in the long term,and hospitalization costs caused by cardiovascular and cerebrovascular diseases are also increasing in recent decades,mainly by ASCVD.The incidence and number of cases of ASCVD continue to increase,and the increasing burden of disease poses great challenges and pressures to health care systems,social support teams,and countless families.To study the effects of a multidisciplinary team management model centered on general practitioners on the level control of risk factors,medication compliance,anxiety and depression in ASCVD patients,and to conduct a preliminary evaluation of its effectiveness.Methods:1.In this study,160 ASCVD patients who met the inclusion criteria and visited a community health service center in Zhengzhou from January 2020 to December 2020 were selected as the research objects,and the patients were divided into intervention group(n=80)and control group(n=80)by random number table method.The control group was given routine out-of-hospital management guidance.The intervention group was administered by a general practitioners centered multidisciplinary team in addition to the control group.The control of cardiovascular risk factors in two groups before and 6 months after intervention was observed.The improvement of medication compliance,anxiety and depression in the two groups was observed before intervention,3 months after intervention and 6 months after intervention.2.Observation indicatorsCardiovascular risk factors: low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),systolic blood pressure(SBP),fasting blood glucose(FBG),body mass index(BMI),blood uric acid(UA)before and after intervention in two groups;Scale evaluation indexes: scores of medication compliance(MMAS-8),generalized anxiety Scale-7(GAD-7)and health questionnaier-9(PHQ-9)scales in two groups before and after intervention;3.EXCEL was used to input data,SPSS 26.0 software was used for data analysis and processing.T test was used for measurement data conforming to normal distribution and homogeneity of variance,and approximate T test was used for variance variance.Rank sum test was used for measurement data that did not conform to normal distribution.For repeated measurement,repeated measures analysis of variance(r ANOVA)was used and ε correction coefficient was used to select the method.Chi-square test was used for counting data.If the calculated value is less than 5,Fisher’s exact test is used.P < 0.05 was considered statistically significant.Results:1.Comparison of baseline data: there were 80 patients in the intervention group and 80 patients in the control group.Baseline comparison of demographic and sociological data and clinical data of the two groups before intervention showed no statistical significance(P > 0.05).2.Comparison of control levels of risk factors: Before intervention: there was no statistical significance in LDL-C,TC,TG,SBP,FBG,BMI and UA between two groups(P > 0.05);6 months after intervention: Intra-group comparison: LDL-C,TC,TG,SBP,FBG,and UA in the intervention group were significantly lower than those before intervention,with statistical significance(P < 0.05);Comparison between groups: There were statistically significant differences in LDL-C,TC,TG and SBP between the two groups(P < 0.05).3.Comparison of medication compliance score: Before intervention: there was no statistical significance in the total compliance score between the two groups(P > 0.05);3 and 6 months after intervention: the total compliance score in the intervention group was significantly higher than that in the control group,and the differences were statistically significant(P < 0.01).Repeated measures analysis of variance(r ANOVA)showed interaction between intervention effect and time effect(F interaction =14.988,P < 0.01).4.Comparison of anxiety and depression scores: Before intervention: there was no statistical significance in the scores of anxiety and depression between the two groups(P > 0.05);3 and 6 months after intervention: the scores of anxiety and depression in the intervention group were higher than those in the control group,and the differences were statistically significant(P < 0.05).Repeated measure analysis of variance(r ANOVA)showed interaction between intervention effect and time effect(F anxiety interaction=46.652,P < 0.01),(F depression interaction =43.536,P < 0.01).Conclusion:The multidisciplinary team management model centered on general practitioners has improved the control level of cardiovascular risk factors in patients with ASCVD,and has played a positive role in the improvement of medication compliance,anxiety and depression,which has played a guiding role in the health management of patients with ASCVD.