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加拿大抗中性粒细胞胞浆抗体相关血管炎管理建议的制定:全国需求评估问卷结果

Development of Canadian Recommendations for the Management of ANCA-Associated Vasculitides: Results of the National Needs Assessment Questionnaire.

作者信息

Famorca Leilani, Twilt Marinka, Barra Lillian, Bakowsky Volodko, Benseler Susanne, Cabral David, Carette Simon, Dhindsa Navjot, Fifi-Mah Aurore, Goulet Michelle, Khalidi Nader, Khraishi Majed, McGeoch Lucy, Milman Nataliya, Pineau Christian, Shojania Kam, Taylor-Gjevre Regina, Towheed Tanveer, Trudeau Judith, Yacyshyn Elaine, Liang Patrick, Pagnoux Christian

机构信息

Langs Community Centre, Cambridge, Ontario, Canada.

Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Open Rheumatol J. 2015 Apr 14;9:16-20. doi: 10.2174/18743129014090100016. eCollection 2015.

Abstract

OBJECTIVES

To study variations in Canadian clinical practice patterns for the management of ANCA-associated vasculitis (AAV) and identify points to consider for the development of national recommendations.

MATERIAL AND METHODOLOGY

A 30-item needs assessment questionnaire was sent to all members of the Canadian Vasculitis network (CanVasc), Canadian Rheumatology Association (CRA), Canadian Thoracic Society (CTS) and Canadian Society of Nephrology (CSN). Respondent characteristics, practice patterns, concerns and expectations were analyzed.

RESULTS

Among 132 physicians who followed at least 1 vasculitis patient and responded to the survey, 39% stated that they felt confident in their management of AAV. Several variations in practice were observed regarding diagnostic procedure, induction and maintenance treatments and use of biologics; some were due to logistic constraints (difficulties in access to some specific tests, drugs or care; lack of health care coverage for the costs). The top 5 topics for which recommendations are expected involve treatment for remission induction, maintenance, refractory disease, and relapse as well as biologics.

CONCLUSION

Practice variations identified in this needs assessment survey will serve to formulate key questions for the development of CanVasc recommendations.

摘要

目的

研究加拿大抗中性粒细胞胞浆抗体相关性血管炎(AAV)管理方面临床实践模式的差异,并确定制定国家建议时需考虑的要点。

材料与方法

向加拿大血管炎网络(CanVasc)、加拿大风湿病协会(CRA)、加拿大胸科学会(CTS)和加拿大肾脏病学会(CSN)的所有成员发送了一份包含30个条目的需求评估问卷。分析了受访者的特征、实践模式、关注点和期望。

结果

在至少随访过1例血管炎患者并回复调查的132名医生中,39%表示对AAV的管理有信心。在诊断程序、诱导和维持治疗以及生物制剂的使用方面观察到了一些实践差异;有些是由于后勤限制(获取某些特定检查、药物或护理困难;缺乏医疗费用覆盖)。预计提出建议的前5个主题涉及诱导缓解治疗、维持治疗、难治性疾病、复发以及生物制剂。

结论

本次需求评估调查中确定的实践差异将有助于为制定CanVasc建议提出关键问题。

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