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关于多普勒超声在类风湿关节炎疾病活动度评估及教育方面的认知

Perceptions of Doppler ultrasound for rheumatoid arthritis disease activity assessment and education.

作者信息

Joshua Fredrick, Bailey Christine, Marabani Mona, Romas Evange, White Raymond, Wong Peter

机构信息

Combined Rheumatology Practice and Macquarie University, Sydney, New South Wales, Australia.

AbbVie Australia, Sydney, New South Wales, Australia.

出版信息

Int J Rheum Dis. 2019 Jan;22(1):55-61. doi: 10.1111/1756-185X.13034. Epub 2017 Feb 16.

Abstract

AIM

The aim of this qualitative study was to report the findings of the Defining rheumatoid arthritis progression using Doppler Ultrasound in Clinical practice (DEDUCE) Medical Practice Activity, which was developed to facilitate the utilization of Doppler ultrasound (DUS) by Australian rheumatologists in the treatment of patients with rheumatoid arthritis (RA).

METHOD

Twenty-one rheumatologists recruited a total of 80 patients with RA in Disease Activity Score of 28 joints (DAS28) remission for DUS assessment and completed a pre- and post-activity questionnaire assessing their experience with DUS, as well as a 6-month follow-up questionnaire. Rheumatologists discussed DUS results with patients using visual aids. Patients completed a pre- and post-DUS assessment questionnaire. Data were summarized using descriptive statistics.

RESULTS

Following completion of the activity, 95% of rheumatologists (20/21) believed DUS was a useful assessment tool for patients with RA. The majority found the DUS results useful and more than half thought the DUS assessment fit well into their consultation. A majority of rheumatologists indicated they would use DUS imaging in patients with low disease activity and remission, and for disease activity assessment to inform in therapeutic decision-making. All patients who responded found the visual aids useful and most felt that discussing DUS results improved understanding of their disease and would help with medication adherence.

CONCLUSION

Incorporation of DUS imaging into routine clinical practice is feasible, encourages rheumatologists to utilize and expand their clinical application of DUS imaging in patients with RA, and may improve patient understanding of their disease and adherence to medication.

摘要

目的

本定性研究旨在报告“临床实践中使用多普勒超声定义类风湿关节炎进展(DEDUCE)”医疗实践活动的结果,该活动旨在促进澳大利亚风湿病学家在类风湿关节炎(RA)患者治疗中使用多普勒超声(DUS)。

方法

21名风湿病学家招募了总共80名处于28个关节疾病活动评分(DAS28)缓解期的RA患者进行DUS评估,并完成一份活动前后的问卷,评估他们使用DUS的经验,以及一份6个月的随访问卷。风湿病学家使用视觉辅助工具与患者讨论DUS结果。患者完成一份DUS评估前后的问卷。数据使用描述性统计进行汇总。

结果

活动结束后,95%的风湿病学家(20/21)认为DUS是RA患者的一种有用评估工具。大多数人认为DUS结果有用,超过一半的人认为DUS评估很适合他们的会诊。大多数风湿病学家表示,他们会在疾病活动度低和缓解期的患者中使用DUS成像,并用于疾病活动度评估以指导治疗决策。所有做出回应的患者都认为视觉辅助工具有用,大多数人觉得讨论DUS结果能增进对自身疾病的了解,并有助于提高用药依从性。

结论

将DUS成像纳入常规临床实践是可行的,鼓励风湿病学家在RA患者中使用并扩大DUS成像的临床应用,且可能会提高患者对自身疾病的了解和用药依从性。

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