Massardo Loreto, Suárez-Almazor María E, Cardiel Mario H, Nava Arnulfo, Levy Roger A, Laurindo Ieda, Soriano Enrique R, Acevedo-Vázquez Eduardo, Millán Alberto, Pineda-Villaseñor Carlos, Galarza-Maldonado Claudio, Caballero-Uribe Carlo V, Espinosa-Morales Rolando, Pons-Estel Bernardo A
Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Clin Rheumatol. 2009 Jun;15(4):203-10. doi: 10.1097/RHU.0b013e3181a90cd8.
A consensus meeting of representatives of 18 Latin-American and Caribbean countries gathered in Reñaca, Chile, for 2 days to identify problems and provide recommendations for the care of patients with rheumatoid arthritis (RA) in Latin America, a region where poverty and other health priorities make the efforts to provide effective and high quality care difficult. This report includes recommendations for health professionals, patients, and health authorities in Latin America, with an emphasis on education and therapeutic issues.
Fifty-one rheumatologists (list available only online on the JCR website) from 18 Latin-American and Caribbean countries with a special interest in RA participated in the consensus meeting. Participants were experts identified and appointed by the National Societies of Rheumatology affiliated with the Pan-American League of Associations for Rheumatology (PANLAR) and by the Grupo Latino Americano De Estudio de Artritis Reumatoide (GLADAR)-an independent group of Latin American rheumatologist researchers were also invited to the meeting. Eight topics were identified as priorities: patient, community and allied health professional education, health policy and decision making, programs for early detection and appropriate treatment of RA, role of classic disease modifying antirheumatic drugs (DMARDs), role of biologic therapy, and drug safety surveillance. To reach consensus, a survey with questions relevant to the topic of interest was sent to all participants before the meeting. During a 2 day meeting, the answers of the survey were reviewed and discussed by each group, with final recommendations on action items.
The specific topic of the survey was answered by 86% of the participants and 68% of them answered the entire survey. It was agreed that RA and rheumatic diseases which are currently not but should be public health priorities in Latin America, because of their prevalence and impact on quality of life.
Strategic areas identified as priorities for our region included: early diagnosis and access to care by multidisciplinary teams, creation of databases to identify infections with the use of biologic agents in RA which are relevant to Latin America, and overall efforts to improve the care of RA patients in accordance with international standards. Implementation of educational programs aimed to improve self-management for patients with RA was also considered crucial.
18个拉丁美洲和加勒比国家的代表齐聚智利雷尼亚卡，举行为期两天的共识会议，以确定问题，并为拉丁美洲类风湿关节炎（RA）患者的护理提供建议。在该地区，贫困和其他卫生优先事项使得提供有效且高质量的护理工作面临困难。本报告包括针对拉丁美洲卫生专业人员、患者和卫生当局的建议，重点是教育和治疗问题。
来自18个拉丁美洲和加勒比国家、对RA有特别兴趣的51名风湿病学家（名单仅在JCR网站在线提供）参加了共识会议。参与者是由泛美风湿病协会联盟（PANLAR）下属的各国风湿病学会以及拉丁美洲类风湿关节炎研究小组（GLADAR）——一个由拉丁美洲风湿病研究人员组成的独立团体确定并任命的专家。会议确定了八个优先主题：患者、社区及相关卫生专业人员教育、卫生政策与决策、RA早期检测及适当治疗项目、传统改善病情抗风湿药（DMARDs）的作用、生物治疗的作用以及药物安全监测。为达成共识，会前向所有参与者发送了一份与感兴趣主题相关问题的调查问卷。在为期两天的会议期间，各小组对调查问卷的答案进行了审查和讨论，并就行动项目提出了最终建议。
86%的参与者回答了调查问卷的具体主题，其中68%的人回答了全部问卷。与会者一致认为，鉴于RA和风湿性疾病的患病率及其对生活质量的影响，它们目前虽不是但应成为拉丁美洲的公共卫生优先事项。
确定为我们地区优先事项的战略领域包括：早期诊断以及多学科团队提供护理、建立数据库以识别拉丁美洲RA患者使用生物制剂时相关的感染情况，以及按照国际标准全面努力改善RA患者的护理。实施旨在改善RA患者自我管理的教育项目也被认为至关重要。
