Analysis of the effect of patients care on the level of sputum specimens submitted for examination among outpatient follow-up of rifampicin-resistant pulmonary tuberculosis patients

doi:10.3969/j.issn.1000-6621.2021.10.013

Abstract

Abstract:

Objective To assess the effect of the patients care on the level of sputum specimens submitted for examination among the outpatient follow-up of rifampicin-resistant pulmonary tuberculosis (RR-PTB) patients. Methods The RR-PTB outpatients followed-up in Drug-Resistant TB Department of Xi’an Chest Hospital were taken as objects. The RR-PTB outpatients followed-up from July to September 2019 were taken as the intervention group 1 (249 cases) who received 3 care services in the first phase. The intervention group 2 (239 cases) were the RR-PTB outpatient followed-up from July to September 2020 who received 6 care services in the second-phase. Meanwhile, RR-PTB outpatients who followed-up from July to September 2018 received routine outpatient expectoration guidance were retrospectively analyzed as the control group (127 cases). The changes of the rate of sputum specimens submitted for examination of the 3 groups were compared. Results The overall rate of sputum specimens submitted for examination in the control group, intervention group 1 and intervention group 2 were 35.8% (77/215), 51.7% (209/404) and 78.6% (276/351) separately, the difference was statistically significant (χ²=111.249, P<0.001). The rate in the intervention group 1 received the first intervention (47.0%, 117/249) and the group 2 received the first intervention (73.6%,176/239) were significantly higher than that of control group (29.9%, 38/127), the difference was statistically significant (χ²=10.110, 65.278;P<0.017). The rate of the intervention group 2 was significantly higher than the group 1 (χ²=36.106, P<0.001). The rates of intervention group 1 after receiving the first intervention, the second intervention and third intervention were 47.0% (117/249), 57.4% (78/136) and 73.7% (14/19), respectively, and the differences were significant (χ_trends²=7.448, P=0.006). The rates of the intervention group 2 received first intervention and the second intervention were 73.6% (176/239) and 89.3% (100/112) respectively, and the difference was significant (χ²=11.111, P=0.001). Conclusion Patient care services can increase the rate of sputum specimens submitted for examination among the followed-up RR-PTB outpatients, and the effects of 6 care services were better than that of 3 care services.

Key words: Tuberculosis, multidrug resistance, Rifampicin, Patient care management, Sputum, Patient care, Comparative study

LUO Hui, RUAN Yun-zhou, ZHAO A-li, YUAN Rong, HE Xiao-mou, LI Ren-zhong. Analysis of the effect of patients care on the level of sputum specimens submitted for examination among outpatient follow-up of rifampicin-resistant pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2021, 43(10): 1046-1051. doi: 10.3969/j.issn.1000-6621.2021.10.013

Figures/Tables 4

References 14

[1]	中华人民共和国国家卫生健康委员会办公厅. 国家卫生健康委办公厅关于印发中国结核病预防控制工作技术规范(2020年版)的通知. 国卫办疾控函〔2020〕279号. 2020-04-02.
[2]	段鸿飞, 初乃惠. 抗结核药品临床试验疗效评价指标的研究进展. 中国防痨杂志, 2021, 43(1): 96-99. doi: 10.3969/j.issn.1000-6621.2021.01.018. doi: 10.3969/j.issn.1000-6621.2021.01.018
[3]	World Health Organization. WHO consolidated guideline on drug-resistant tuberculosis treatment. Geneva: World Health Organization, 2019.
[4]	Jiang Q, Ji L, Qiu Y, et al. A randomised controlled trial of stepwise sputum collection to increase yields of confirmed tuberculosis. Int J Tuberc Lung Dis, 2019, 23(6): 685-691. doi: 10.5588/ijtld.18.0524. doi: 10.5588/ijtld.18.0524 pmid: 31315700
[5]	中华人民共和国国家卫生和计划生育委员会. WS 288—2017肺结核诊断. 2017-11-09.
[6]	中国防痨协会. 耐药结核病化学治疗指南(2019年). 北京: 人民卫生出版社, 2019.
[7]	黄雪欢, 沈惠兰, 曾华志, 等. 质量控制小组对提高结核科患者痰标本采集质量的作用. 中国防痨杂志, 2016, 38(12): 1078-1081. doi: 10.3969/j.issn.1000-6621.2016.12.014. doi: 10.3969/j.issn.1000-6621.2016.12.014
[8]	陈晓凤, 王秀华, 聂菲菲. 肺结核患者关怀与支持干预研究进展. 中国防痨杂志, 2019, 41(7): 775-778. doi: 10.3969/j.issn.1000-6621.2019.07.014. doi: 10.3969/j.issn.1000-6621.2019.07.014
[9]	Nunes SA, Ignez SJ, Mendonca LFB, et al. Educational intervention for collecting sputum for tuberculosis: a quasi-experimental study. Revista Latino Americana De Enfermagem, 2016, 24: e2703. doi: 10.1590/1518-8345.0363.270. doi: 10.1590/1518-8345.0363.270
[10]	Mathebula U, Emerson C, Agizew T, et al. Improving sputum collection processes to increase tuberculosis case finding among HIV-positive persons in Botswana. Public Health Action, 2020, 10(1): 11-16. doi: 10.5588/pha.19.0051. doi: 10.5588/pha.19.0051 pmid: 32368518
[11]	Saint-Pierre C, Herskovic V, Sepúlveda M, Multidisciplinary collaboration in primary care: a systematic review. Family Practice, 2018, 35(2): 132-141. doi: 10.1093/fampra/cmx085. doi: 10.1093/fampra/cmx085 pmid: 28973173
[12]	Reeves S, Pelone F, Harrison R, et al. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database Syst Rev, 2017, 6(6): CD000072. doi: 10.1002/14651858.CD000072.pub3. doi: 10.1002/14651858.CD000072.pub3
[13]	周春雷, 裴楠, 孙健. 强化健康教育在糖尿病住院患者中应用效果. 中国实用医药, 2018, 13(3): 176-177. doi: 10.14163/j.cnki.11-5547/r.2018.03.107. doi: 10.14163/j.cnki.11-5547/r.2018.03.107
[14]	朱金荣, 门海燕, 赵微微, 等. 强化健康教育在持续反复高磷血症血液透析患者中的应用. 中国护理管理, 2018, 18(8): 1148-1152. doi: 10.3969/j.issn.1672-1756.2018.08.030. doi: 10.3969/j.issn.1672-1756.2018.08.030

一般特征	对照组(127例)	观察组1(249例)	观察组2(239例)	χ²值	P值
性别				2.428	0.297
男性	80(63.0)	176(70.7)	159(66.5)
女性	47(37.0)	73(29.3)	80(33.5)
年龄组(岁)				7.560	0.109
<18	7(5.5)	7(2.8)	2(0.8)
18~59	108(85.1)	214(86.0)	213(89.2)
≥60	12(9.4)	28(11.2)	24(10.0)
文化程度				1.937	0.747
小学及以下	9(7.1)	15(6.0)	16(6.7)
初中及高中	95(74.8)	195(78.3)	175(73.2)
大专及以上	23(18.1)	39(15.7)	48(20.1)
并发糖尿病				0.481	0.786
有	12(9.4)	26(10.4)	28(11.7)
无	115(90.6)	223(89.6)	211(88.3)
居住地				4.922	0.085
西安市	64(50.4)	147(59.0)	149(62.3)
西安市以外	63(49.6)	102(41.0)	90(37.7)
医疗费用支付方式				3.219	0.200
医疗保险	103(81.1)	206(82.7)	209(87.4)
自费	24(18.9)	43(17.3)	30(12.6)

组别	患者数	应送检次数	实际送检次数	送检率(%)	χ²值	P值
观察组1	249	249	117	47.0	10.110^a	0.001
观察组2	239	239	176	73.6	65.278^b	0.000
对照组	127	127	38	29.9	36.106^c	0.000

[1]	Li Yuhong, Mei Jinzhou, Su Wei, Ruan Yunzhou, Liu Yushu, Zhao Yanlin, Liu Xiaoqiu. Analysis of the treatment outcomes and influencing factors of rifampicin-resistant pulmonary tuberculosis patients aged 65 and above in China from 2015 to 2021 [J]. Chinese Journal of Antituberculosis, 2025, 47(4): 408-415.
[2]	Jia Hui, Jing Hui, Ling Xiaojie, Wang Yan, Li Xuezheng. The diagnostic value of GeneXpert MTB/RIF Ultra in detecting sputum samples for newly diagnosed pulmonary tuberculosis [J]. Chinese Journal of Antituberculosis, 2025, 47(3): 298-304.
[3]	Xue Yi, Liang Qian, Qi Haoran, Liang Ruixia, Huang Hairong. Reliability analysis of rifampicin-resistance detected by different diagnostics as a predictor for multidrug-resistant tuberculosis [J]. Chinese Journal of Antituberculosis, 2024, 46(8): 892-896.
[4]	Zhang Hongtai, Ren Yixuan, Hu peilei, Wang Nenhan, Li Jie, Tian Lili, Zhao Yanfeng, Chen Shuangshuang, Li Chuanyou. Comparison of microbiota diversity in the sputum of pulmonary tuberculosis patients with rifampicin resistance or sensitivity [J]. Chinese Journal of Antituberculosis, 2024, 46(6): 625-633.
[5]	Du Yuhua, Feng Yajuan, Lei Yu, Lai Keng, He Weiyun. Analysis of the detection and treatment of rifampicin-resistant pulmonary tuberculosis patients in Guangzhou during the “12th Five-Year Plan” and “13th Five-Year Plan” periods [J]. Chinese Journal of Antituberculosis, 2024, 46(6): 678-686.
[6]	Song Hongge, Liu Weigao, Chen Li. A comparative study on the therapeutic effects of total hip joint type spacer and pressure model spacer in patients with mid to late stage hip tuberculosis [J]. Chinese Journal of Antituberculosis, 2024, 46(5): 562-566.
[7]	Li Ting, Liu Shuang, Wang Danxia, Lu Jia, Cheng Qianqian, Chen Chuang, He Jin’ge, Zhang Linglin, Xia Yong, Li Jing, Zhang Shu, Gao Wenfeng, Xia Lan. Evaluation of health economics of implementation of tuberculosis prevention and control program in Sichuan Province from 2011 to 2020 [J]. Chinese Journal of Antituberculosis, 2024, 46(3): 333-339.
[8]	Gulina Badeerhan, Liu Nianqiang, Yipaer Aihaiti, Wang Le, Wang Senlu, Zulikatiayi Abudula, Wang Mingzhe, Zhang Jing, Wang Xinqi, Bi Hongbo. The effect of GeneXpert MTB/RIF detection technology in tuberculosis prevention and control program in Xinjiang [J]. Chinese Journal of Antituberculosis, 2024, 46(2): 173-177.
[9]	Ge Jing, Wang Jun, He Yuqi, Nie Wenjuan. Six cases of pseudomembranous colitis caused by anti-tuberculosis drugs and literature review [J]. Chinese Journal of Antituberculosis, 2024, 46(11): 1320-1326.
[10]	Liu Shuren, Fu Lin, Wang Lianbo, Zhao Guisong, Li Zhuo, Dong Zhaoliang. Application of blood management in the perioperative period of lumbar tuberculosis under the concept of enhanced recovery after surgery [J]. Chinese Journal of Antituberculosis, 2024, 46(11): 1343-1349.
[11]	Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis, Beijing Chest Hospital, Capital Medical University. Expert consensus on clinical monitoring and management of QTc interval prolongation caused by anti-tuberculous drugs [J]. Chinese Journal of Antituberculosis, 2024, 46(1): 8-17.
[12]	Qin Huifang, Liang Xiaoyan, Zhou Lingyun, Lan Yumei, Lin Mei, Zhang Zhitong, Huang Yan, Wei Xiaolin, Liang Dabin. Analysis on the effect of GeneXpert MTB/RIF single test and mixed test on sputum samples for actively screening tuberculosis in key population of Guangxi [J]. Chinese Journal of Antituberculosis, 2023, 45(9): 880-884.
[13]	Song Ruixue, Wei Rongrong, Dong Jing, Jia Hongyan, Du Boping, Sun Qi, Xing Aiying, Li Zihui, Zhu Chuanzhi, Zhang Zongde, Pan Liping. The performance of interferon gamma-induced protein 10 mRNA detection technology in auxiliary diagnosis of tuberculosis [J]. Chinese Journal of Antituberculosis, 2023, 45(5): 471-476.
[14]	Yan Xiaojing, Wang Qingfeng, Yang Yang, Chu Naihui, Nie Wenjuan. Diagnostic value of a nanopore sequencing assay of bronchoalveolar lavage fluid in smear-negative pulmonary tuberculosis [J]. Chinese Journal of Antituberculosis, 2023, 45(5): 487-492.
[15]	Liu Yueyuan, Su Wei, Zheng Jiangang, Wang Meng, Zeng Zhong, Huang Qin, Xie Tian, Li Renzhong. Study on the role of the prefectural tuberculosis designated hospital to improve the case finding of pulmonary tuberculosis in economic undeveloped areas of Jiangxi Province [J]. Chinese Journal of Antituberculosis, 2023, 45(3): 279-284.