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德国强直性脊柱炎和银屑病关节炎患者的医疗状况:脊柱关节炎(SpA)患者的医疗状况:从德国私人诊所和医院的风湿病学家角度看强直性脊柱炎(AS)和银屑病关节炎(PsA)——“SpA Loop - 门诊患者生活”研究项目的结果

[Medical care situation of patients with ankylosing spondylitis and psoriatic arthritis in Germany : Medical care situation of patients with spondyloarthritis (SpA): ankylosing spondylitis (AS) and psoriatic arthritis (PsA) from the perspective of rheumatologists in private practice and hospitals in Germany-Results of the research project "SpA Loop-Life of Outpatients"].

作者信息

Braun J, Schwarting A, Hammel L, Legeler C, Wimmer P, Färber L, Behrens F

机构信息

Rheumazentrum Ruhrgebiet, Herne, Deutschland.

Rheumatologie und klinische Immunologie, Universitätsmedizin Mainz und Rheumazentrum Rheinland-Pfalz, Mainz, Deutschland.

出版信息

Z Rheumatol. 2019 May;78(4):372-381. doi: 10.1007/s00393-019-0619-6.

Abstract

BACKGROUND

The prevalence of spondyloarthritis (SpA) in Germany is approximately 1-1.4% and includes predominantly axial SpA (axSpA) and predominantly peripheral SpA. Ankylosing spondylitis (AS) belongs to the group of axial SpA but also exhibits peripheral manifestations. Psoriatic arthritis (PsA) can show purely peripheral or also axial manifestations. The total prevalence of SpA in Germany is approximately 1‑1.4%, the prevalence of AS is ca. 0.5% and PsA 0.2-1.4%. Patients with AS are mainly treated by internal medical rheumatologists but in many places also basically treated by general practitioners and orthopedists. Patients with PsA are mainly diagnosed and treated by rheumatologists and dermatologists working in private practice or in clinical settings. Besides the control of inflammatory activity and prevention or slowing down of the characteristic disease progression, including irreversible structural changes, the main objectives of patients as well as treating physicians are particularly freedom from pain and a quality of life comparable to non-affected persons. Decisive for successful treatment are an early diagnosis and initiation of adequate therapy as well as regular monitoring of disease activity including treatment adjustment taking the needs of the patient into consideration; however, it is unknown how often this is actually successful in routine daily practice in Germany.

OBJECTIVE

The aim of the SpA Loop research project was to display the current medical care situation of patients with AS and PsA treated in private practices and hospitals for rheumatology in Germany focusing on patient/physician profiles as well as the diagnostics and treatment.

MATERIAL AND METHODS

The instrument for the survey was a standardized questionnaire with 29 multiple choice and perception questions that was distributed to medical specialists in the field of internal medicine and rheumatology.

RESULTS

A high accordance between rheumatologists in private practice and in hospitals was observed with respect to the presentation and perception of the current medical care situation for patients with AS and PsA in Germany. Differences were only occasionally found.

CONCLUSION

The results of this research project reflect the current status of the medical care situation of AS and PsA patients in Germany. They provide information on which areas of the medical care situation can selectively be improved as well as on interesting aspects and points of discussion with respect to the patient population treated.

摘要

背景

德国脊柱关节炎(SpA)的患病率约为1%-1.4%,主要包括中轴型SpA(axSpA)和外周型SpA。强直性脊柱炎(AS)属于中轴型SpA,但也有外周表现。银屑病关节炎(PsA)可表现为单纯外周型或也有中轴表现。德国SpA的总患病率约为1%-1.4%,AS的患病率约为0.5%,PsA的患病率为0.2%-1.4%。AS患者主要由内科风湿病专家治疗,但在许多地方全科医生和骨科医生也进行基本治疗。PsA患者主要由私人诊所或临床环境中的风湿病专家和皮肤科医生诊断和治疗。除了控制炎症活动以及预防或减缓包括不可逆结构改变在内的特征性疾病进展外,患者和治疗医生的主要目标尤其包括摆脱疼痛以及拥有与未患病者相当的生活质量。成功治疗的关键是早期诊断、开始适当治疗以及定期监测疾病活动,包括根据患者需求调整治疗;然而,在德国日常临床实践中这实际能成功的频率尚不清楚。

目的

SpA Loop研究项目的目的是展示在德国私人诊所和风湿病医院接受治疗 的AS和PsA患者的当前医疗状况,重点关注患者/医生概况以及诊断和治疗情况。

材料与方法

调查工具是一份标准化问卷,包含29个多项选择题和认知问题,分发给内科和风湿病领域的医学专家。

结果

观察到私人诊所和医院的风湿病专家对德国AS和PsA患者当前医疗状况的呈现和认知高度一致。仅偶尔发现差异。

结论

该研究项目的结果反映了德国AS和PsA患者的当前医疗状况。它们提供了关于医疗状况哪些领域可选择性改善的信息,以及关于所治疗患者群体的有趣方面和讨论要点的信息。

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