Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Division of Internal Medicine, Kantonsspital Langenthal, Solothurn, Switzerland.
Aliment Pharmacol Ther. 2018 Nov;48(10):1082-1090. doi: 10.1111/apt.15000.
Well informed patients who are in cohesive partnership with physicians and who have realistic expectations towards therapy are more likely to be adherent, which results in better disease control.
To assess which therapy goals adults with eosinophilic oesophagitis consider relevant.
Following refinement during three focus groups, a study brochure and questionnaire were sent to 148 patients. Patients ranked the importance (five levels) of short-term (in the next 3 months) and long-term (≥1 year) treatment effect on symptoms, quality of life (QoL), histologically-detected inflammation and fibrosis, endoscopically-detected inflammation, and stricture formation as well as achieving histological remission while asymptomatic. Patients' characteristics associated with treatment goals were identified using logistic regression.
Of 109 respondents (mean age 43 years), 85 were men. Over 90% chose symptoms and QoL improvement as important short- and long-term therapy goals. A greater proportion attributed more importance to long-term reduction in endoscopic (90% vs 73%, P < 0.001) and histological (81% vs 62%, P = 0.002) inflammation, and histologically-detected fibrosis (79% vs 64%, P = 0.018) when compared to short-term reduction in these features. Patients (88%) ranked achieving histological remission while being asymptomatic as important. Gender, therapy use, education level, QoL, symptom severity, and history of dilation were associated with patients' choice of treatment goals.
Patients attributed most importance to improvement in symptoms and QoL. Reduction in biological activity was judged less important, but more relevant in the long- compared to the short-term.
与医生紧密合作且对治疗有合理期望的知情患者更有可能坚持治疗,从而实现更好的疾病控制。
评估成人嗜酸性食管炎患者认为哪些治疗目标是相关的。
经过三轮焦点小组讨论后对研究手册和问卷进行了修订,随后将其发送给 148 名患者。患者对症状、生活质量(QoL)、组织学炎症和纤维化、内镜下炎症、狭窄形成以及无症状时达到组织学缓解的短期(未来 3 个月内)和长期(≥1 年)治疗效果的重要性(五个等级)进行了评分。使用逻辑回归识别与治疗目标相关的患者特征。
在 109 名应答者(平均年龄 43 岁)中,85 人为男性。超过 90%的患者选择改善症状和 QoL 作为短期和长期治疗的重要目标。更多患者认为长期内镜(90%比 73%,P<0.001)和组织学(81%比 62%,P=0.002)炎症以及组织学检测到的纤维化(79%比 64%,P=0.018)的减轻比短期减轻更为重要。患者(88%)认为无症状时达到组织学缓解也很重要。性别、治疗方式、教育程度、QoL、症状严重程度和扩张史与患者的治疗目标选择有关。
患者最看重症状和 QoL 的改善。减轻生物学活性的重要性较低,但与短期相比,长期治疗更相关。