“人G共生”管理模式在房颤患者NOAC管理中的应用及效果评估

Application and Effect Evaluation of “Human-GenAI Coexistence” Management Model in NOAC Therapy for Patients with Atrial Fibrillation

关键词:  房颤  非维生素K拮抗剂口服抗凝药  人G共生  抗凝管理模式

Key words:  atrial fibrillation  non-vitamin K antagonist oral anticoagulants  Human-GenAI Coexistence  anticoagulation management model

摘要:

目的：旨在评估“人G共生”管理模式在非维生素K拮抗剂口服抗凝药(NOAC)治疗中的应用效果,尤其关注其对患者管理质量的影响。方法：选取2024年5月至2025年5月期间在仁济医院接受NOAC治疗的220名房颤患者,将其随机分配到观察组和对照组。对照组患者接受传统的普通门诊管理,观察组患者在常规管理的基础上,由医师-药师联合门诊基于“人G共生”创新管理模式,为患者提供决策支持及全程管理。研究主要比较两组患者的临床不良事件发生率、处方合理率、患者口服抗凝药知识水平、依从性和抗凝治疗满意度。结果：6个月随访结果显示,与对照组相比,观察组患者在抗凝治疗依从性评分(7.90±0.40 vs. 7.73±0.60, P = 0.014)、抗凝负担评分(51.72±2.99 vs. 50.67±3.62, P = 0.021)以及抗凝获益评分(12.46±2.35 vs. 10.85±1.76, P ＜ 0.001)方面均有显著改善；两组抗凝治疗知识评分均明显升高,且观察组平均得分显著高于对照组(18.26±4.49 vs. 15.74±3.77, P ＜ 0.001)。在NOAC处方合理性评估中,观察组处方合理率显著高于对照组(96.36% vs. 88.18％,P = 0.023)。此外,观察组的不良事件发生率略低于对照组,但组间差异无统计学意义。结论：“人G共生”抗凝管理模式通过“医疗团队-GenAI-患者”三方协同创新机制,能够显著提升房颤患者NOAC治疗的依从性、抗凝知识掌握度、治疗满意度及处方合理性,有效促进NOAC的规范化应用,为提高房颤抗凝管理效能提供了重要参考。

Abstract:

OBJECTIVE This study aims to evaluate the efficacy of the “Human-GenAI Coexistence” management model among patients with atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants (NOAC), , with a particular focus on its impact on the quality of patient management. METHODS This study enrolled 220 patients with atrial fibrillation who were undergoing NOAC therapy at Renji Hospital from May 2024 to May 2025. The patients were randomly assigned to control group and observation group. The control group received management according to the standard outpatient care model, whereas the intervention group, in addition to standard care, received decision support and comprehensive management from a collaborative physician-pharmacist clinic, following the innovative “Human-GenAI Coexistence” management model. The knowledge, adherence, and satisfaction with anticoagulation therapy, adverse event incidence, and prescription qualification rate were all compared between the two groups. RESULTS The 6-month follow-up data revealed that, compared to the control group, the observation group demonstrated significantly greater improvements in adherence scores (7.90±0.40 vs. 7.73±0.60, P = 0.014), anticoagulation burden scores (51.72±2.99 vs. 50.67±3.62, P = 0.021), and anticoagulation benefit scores (12.46 ± 2.35 vs. 10.85 ± 1.76, P < 0.001). Both groups experienced significant increases in anticoagulation therapy knowledge scores, with the observation group achieving significantly higher scores than the control group (18.26±4.49 vs. 15.74±3.77, P < 0.001). In assessing the rationality of NOAC prescriptions, the intervention group had a significantly higher prescription qualification rate (96.36% vs. 88.18%, P = 0.023). Additionally, although the incidence of adverse events in the intervention group was slightly lower, no statistically significant difference was observed between the two groups. CONCLUSION Utilizing a tripartite collaborative innovative mechanism that integrates the medical team, GenAI, and patients, the “Human-GenAI Coexistence” anticoagulation management model significantly improves adherence to anticoagulant therapy, acquisition of relevant knowledge, treatment satisfaction and the prescription rationality in atrial fibrillation patients receiving NOAC. This model also effectively fosters the standardized use of NOAC and offers a crucial reference for enhancing the effectiveness of atrial fibrillation anticoagulation management.