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西班牙胃肠病科如何管理炎症性肠病?GESTIONA-EII调查结果。

How is inflammatory bowel disease managed in Spanish gastroenterology departments? The results of the GESTIONA-EII survey.

作者信息

Barreiro-de Acosta Manuel, Argüelles-Arias Federico, Hinojosa Joaquín, Júdez Gutiérrez Francisco Javier, Tenías Burillo Jose Maria

机构信息

Aparato digestivo, Hospital Clínico Universitario de Santiago de Compostela, España.

Aparato Digestivo, Hospital Universitario Virgen Macarena. Sevilla. .

出版信息

Rev Esp Enferm Dig. 2016 Oct;108(10):618-626. doi: 10.17235/reed.2016.4410/2016.

Abstract

INTRODUCTION

Not all national health centers include specialized units or clinicians devoted to inflammatory bowel disease. The goal of the survey was to gain an insight into the management of this disease within Spanish gastroenterology departments via a survey among their members.

MATERIAL AND METHODS

An online survey was conducted in February and March 2015, among SEPD members (2017 clinician members), who were split into three categories: heads of department, general gastroenterologists, and experts in this disease. The results of the last two surveys are reported, including demography-related questions and specific questions on the strategies and resources available for the care of these patients.

RESULTS

A total of 166 responses were received (response rate 8.19%), excluding those from heads of department (previously published). Sixty gastroenterologists considered themselves experts in inflammatory bowel disease, and 106 non-experts in it, the latter being either general gastroenterologists or specialists in other areas, mainly endoscopy. Twenty-eight percent of non-expert gastroenterologists said their hospitals had specific units, with a monographic clinic in 46%. However, 26% reported that they were treating affected patients themselves. Experts in inflammatory bowel disease reported that their institute had resources to support their work, but there was a lack of surgeons with expertise in this condition, particularly in county hospitals.

CONCLUSIONS

At least, within SEPD members, 2 out of 3 experts in inflammatory bowel disease seem to have the resources available for their work (nurses, day unit, telephone line, database, referrals, joint sessions). Although there is room for improvement (email to contact patients, devoted surgeon, absence of referral protocols), and 2 out of 3 are concerned about pharmacy costs. Since a substantial number of patients remain treated by general practitioners, rapid referral programs might be helpful in this setting.

摘要

引言

并非所有国家卫生中心都设有专门针对炎症性肠病的科室或临床医生。本次调查的目的是通过对西班牙胃肠病学部门成员进行调查,深入了解该疾病在这些部门中的管理情况。

材料与方法

2015年2月和3月对西班牙消化疾病学会(SEPD)成员(2017名临床医生成员)进行了在线调查,这些成员分为三类:科室主任、普通胃肠病医生和该疾病专家。报告了最后两次调查的结果,包括与人口统计学相关的问题以及关于这些患者护理可用策略和资源的具体问题。

结果

共收到166份回复(回复率8.19%),不包括科室主任的回复(此前已发表)。60名胃肠病医生认为自己是炎症性肠病专家,106名不是专家,后者要么是普通胃肠病医生,要么是其他领域的专家,主要是内镜专家。28%的非专家胃肠病医生表示他们所在医院设有专门科室,46%设有专题诊所。然而,26%报告称他们自己在治疗患病患者。炎症性肠病专家报告称他们所在机构有支持其工作的资源,但缺乏患有这种疾病专业知识的外科医生,尤其是在县级医院。

结论

至少在SEPD成员中,三分之二的炎症性肠病专家似乎拥有开展工作所需的资源(护士、日间病房、电话线、数据库、转诊、联合会议)。尽管仍有改进空间(通过电子邮件联系患者、专职外科医生、缺乏转诊协议),并且三分之二的专家担心药房费用。由于大量患者仍由全科医生治疗,快速转诊计划在这种情况下可能会有所帮助。

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