Nottingham University Hospitals NHS Trust, Nottingham.
Clin Med (Lond). 2012 Aug;12(4):324-7. doi: 10.7861/clinmedicine.12-4-324.
Here we report on an audit performed to examine compliance with National Institute for Health and Clinical Excellence (NICE) guidelines for the use of anti-tumour necrosis factor alpha (anti-TNFalpha) in treating patients with ankylosing spondylitis (AS). Data from 17 rheumatology centres across the Midlands were collected prospectively from patients with AS attending outpatient clinics and retrospectively in patients receiving anti-TNFalpha but not attending outpatient clinics during the audit. In total, 80% of the 416 patients for whom data were collected were male. Of the 238 patients recruited prospectively, 41% were receiving anti-TNFalpha. Reviewing all patients on anti-TNFalpha (N=275), pre-treatment assessments 12 weeks apart were documented in 55% of patients. After anti-TNFalpha treatment had started, regular 12-weekly assessments occurred in 46% of patients. Therefore, compliance with NICE guidance was found to vary among centres. Based on our audit, clinical capacity, and clinical or patient choice might be influencing the suboptimal adherence seen in assessment timing suggested by NICE guidelines relating to the use of anti-TNFalpha in treating patients with AS.
在这里，我们报告了一项审计，旨在检查英国国家卫生与临床优化研究所 (NICE) 关于使用抗肿瘤坏死因子-α（anti-TNFalpha）治疗强直性脊柱炎（AS）患者的指南的遵守情况。从中部地区的 17 个风湿病中心前瞻性地收集了在门诊就诊的 AS 患者的数据，并在审计期间未在门诊就诊但接受了 anti-TNFalpha 治疗的患者中进行了回顾性数据收集。在收集数据的 416 名患者中，有 80%是男性。在 238 名前瞻性入组的患者中，41%正在接受 anti-TNFalpha 治疗。对所有接受 anti-TNFalpha 治疗的患者（N=275）进行回顾性评估，发现有 55%的患者进行了间隔 12 周的治疗前评估。在开始 anti-TNFalpha 治疗后，46%的患者定期进行了每 12 周的评估。因此，我们发现不同中心之间对 NICE 指南的遵守情况存在差异。根据我们的审计，临床能力以及临床或患者选择可能会影响到在使用 anti-TNFalpha 治疗 AS 患者时与 NICE 指南相关的评估时机方面观察到的非最佳依从性。
