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慢性阻塞性肺疾病管理作为所有慢性呼吸道疾病的典范:呼吸医学第四次共识会议报告

COPD management as a model for all chronic respiratory conditions: report of the 4 Consensus Conference in Respiratory Medicine.

作者信息

Nardini Stefano, De Benedetto Fernando, Sanguinetti Claudio M, Bellofiore Salvatore, Carlone Stefano, Privitera Salvatore, Sagliocca Luciano, Tupputi Emmanuele, Baccarani Claudio, Caiffa Gennaro, Calabrese Maria Consiglia, Capuozzo Antonio, Cauchi Salvatore, Conio Valentina, Coratella Giuseppe, Crismancich Franco, Dal Negro Roberto W, Dellarole Franco, Delucchi Maurizio, Favaretti Carlo, Forte Silvia, Gallo Franca Matilde, Giuliano Riccardo, Grandi Marco, Grillo Antonino, Gualano Maria Rosaria, Guffanti Enrico, Locicero Salvatore, Lombardo Francesco Paolo, Mantero Marco, Marasso Roberto, Martino Laura, Mastroberardino Michele, Mereu Carlo, Messina Roberto, Neri Margherita, Novelletto Bruno Franco, Parente Paolo, Pasquinucci Sergio, Pistolesi Massimo, Polverino Mario, Posca Agnese, Richeldi Luca, Roccia Fernando, Giustini Ettore Saffi, Salemi Michelangelo, Santacroce Salvatore, Schisano Mario, Schisano Matteo, Selvi Eleonora, Silenzi Andrea, Soverina Patrizio, Taranto Claudio, Ugolini Marta, Visaggi Piero, Zanasi Alessandro

机构信息

Italian Respiratory Society - Research Center, Milan, Italy.

Italian Respiratory Society - Executive Committee, Milan, Italy.

出版信息

Multidiscip Respir Med. 2017 Nov 10;12:28. doi: 10.1186/s40248-017-0109-0. eCollection 2017.

Abstract

BACKGROUND

Non-communicable diseases (NCDs) kill 40 million people each year. The management of chronic respiratory NCDs such as chronic obstructive pulmonary disease (COPD) is particularly critical in Italy, where they are widespread and represent a heavy burden on healthcare resources. It is thus important to redefine the role and responsibility of respiratory specialists and their scientific societies, together with that of the whole healthcare system, in order to create a sustainable management of COPD, which could become a model for other chronic respiratory conditions.

METHODS

These issues were divided into four main topics (Training, Organization, Responsibilities, and Sustainability) and discussed at a Consensus Conference promoted by the Research Center of the Italian Respiratory Society held in Rome, Italy, 3-4 November 2016.

RESULTS AND CONCLUSIONS

Regarding training, important inadequacies emerged regarding specialist training - both the duration of practical training courses and teaching about chronic diseases like COPD. A better integration between university and teaching hospitals would improve the quality of specialization. A better organizational integration between hospital and specialists/general practitioners (GPs) in the local community is essential to improve the diagnostic and therapeutic pathways for chronic respiratory patients. Improving the care pathways is the joint responsibility of respiratory specialists, GPs, patients and their caregivers, and the healthcare system. The sustainability of the entire system depends on a better organization of the diagnostic-therapeutic pathways, in which also other stakeholders such as pharmacists and pharmaceutical companies can play an important role.

摘要

背景

非传染性疾病(NCDs)每年导致4000万人死亡。在意大利,慢性阻塞性肺疾病(COPD)等慢性呼吸道非传染性疾病的管理尤为关键,因为这些疾病在该国广泛存在,给医疗资源带来了沉重负担。因此,重新界定呼吸专科医生及其科学学会以及整个医疗系统的作用和责任非常重要,以便建立COPD的可持续管理模式,这可能成为其他慢性呼吸道疾病的典范。

方法

这些问题被分为四个主要主题(培训、组织、责任和可持续性),并在2016年11月3日至4日于意大利罗马举行的意大利呼吸学会研究中心推动的共识会议上进行了讨论。

结果与结论

关于培训,在专科培训方面出现了一些重要不足,包括实践培训课程的时长以及对COPD等慢性疾病的教学。大学与教学医院之间更好的整合将提高专科培训质量。医院与当地社区的专科医生/全科医生(GPs)之间更好的组织整合对于改善慢性呼吸道疾病患者的诊断和治疗途径至关重要。改善护理途径是呼吸专科医生、全科医生、患者及其护理人员以及医疗系统的共同责任。整个系统的可持续性取决于诊断 - 治疗途径的更好组织,其中药剂师和制药公司等其他利益相关者也可以发挥重要作用。

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