Mesa Ruben A, Miller Carole B, Thyne Maureen, Mangan James, Goldberger Sara, Fazal Salman, Ma Xiaomei, Wilson Wendy, Paranagama Dilan C, Dubinski David G, Naim Ahmad, Parasuraman Shreekant, Boyle John, Mascarenhas John O
Division of Hematology and Medical Oncology, Mayo Clinic Cancer Center, Scottsdale, Arizona.
Departments of Internal Medicine and Medical Oncology, St Agnes Hospital, Baltimore, Maryland.
Cancer. 2017 Feb 1;123(3):449-458. doi: 10.1002/cncr.30325. Epub 2016 Sep 30.
This analysis of the myeloproliferative neoplasm (MPN) Landmark survey evaluated gaps between patient perceptions of their disease management and physician self-reported practices.
The survey included 813 patient respondents who had MPNs (myelofibrosis [MF], polycythemia vera [PV], or essential thrombocythemia [ET]) and 457 hematologist/oncologist respondents who treated patients with these conditions.
Greater proportions of physician respondents reported using prognostic risk classifications (MF, 83%; PV, 59%; ET, 77%) compared with patient recollections (MF, 54%; PV, 17%; ET, 31%). Most physician respondents reported that their typical symptom assessments included asking patients about the most important symptoms or a full list of symptoms, whereas many patient respondents reported less specific assessments (eg, they were asked how they were feeling). Many patient respondents did not recognize common symptoms as MPN-related. For example, approximately one-half or more did not believe difficulty sleeping resulted from their MPN (MF, 49%; PV, 64%; ET, 76%). Physician respondents underestimated the proportion of patients who had symptomatic PV or ET at diagnosis compared with patient respondents. There was discordance regarding treatment goals: among patient respondents with MF or PV, "slow/delay progression of condition" was the most important treatment goal, whereas physician respondents reported "symptom improvement" and "prevention of vascular/thrombotic events," respectively. Finally, more than one-third of patient respondents were not "very satisfied" with their physician's overall management/communication.
The care and satisfaction of patients with MPN may be improved with increased patient education and improved patient-physician communication. Cancer 2017;123:449-458. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
这项对骨髓增殖性肿瘤(MPN)标志性调查的分析评估了患者对其疾病管理的认知与医生自我报告的实践之间的差距。
该调查包括813名患有MPN(骨髓纤维化[MF]、真性红细胞增多症[PV]或原发性血小板增多症[ET])的患者受访者以及457名治疗这些疾病患者的血液科医生/肿瘤内科医生受访者。
与患者回忆相比,报告使用预后风险分类的医生受访者比例更高(MF为83%;PV为59%;ET为77%),而患者回忆的比例分别为(MF为54%;PV为17%;ET为31%)。大多数医生受访者报告说,他们典型的症状评估包括询问患者最重要的症状或完整的症状清单,而许多患者受访者报告的评估不太具体(例如,他们被问到感觉如何)。许多患者受访者没有认识到常见症状与MPN相关。例如,大约一半或更多的患者不认为睡眠困难是由他们的MPN引起的(MF为49%;PV为64%;ET为76%)。与患者受访者相比,医生受访者低估了诊断时出现症状性PV或ET的患者比例。在治疗目标方面存在不一致:在患有MF或PV的患者受访者中,“延缓病情进展”是最重要的治疗目标,而医生受访者分别报告为“症状改善”和“预防血管/血栓事件”。最后,超过三分之一的患者受访者对医生的总体管理/沟通“不太满意”。
通过加强患者教育和改善医患沟通,可能会提高MPN患者的护理质量和满意度。《癌症》2017年;123:449 - 458。© 2016作者。《癌症》由威利期刊公司代表美国癌症协会出版。