Chronic diseases
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients older than or equal to 60 years and younger than or equal to 85 years old; 2. Patients with three or more chronic diseases: hypertension, diabetes, hyperlipidemia, cerebral infarction, coronary heart disease, heart failure, chronic obstructive pulmonary disease and bronchial asthma; 3. Patients who are using more than 5 kinds of drugs (chemical drugs); 4. Subjects with medical insurance in Hebei province or Shijiazhuang city.
Exclusion criteria
Exclusion criteria: 1. The life expectancy is less than 12 months; 2. After evaluation, it is impossible to achieve effective communication and regular follow-up with patients; 3. In the period of radiotherapy and chemotherapy for malignant tumor or blood disease; 4. Long-term bedridden patients without relatives for long-term care; 5. Failure to sign informed consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| satisfaction evaluation;All-Cause Mortality;All for readmission;All due to emergency treatment;Chronic disease control rate;Adverse Drug Event;Major adverse cardiac event;Medication compliance;Number of MRPs found;Resolve the number of MRPS;Annual drug expenses;Annual medical expenses;Total annual health expenditure;Effective identification of MRPS quantity;Effectively intervene and address the number of MRPs; | — |
Countries
China
Contacts
The First Hospital of Hebei Medical University