Cheema Tariq J, Young Meilin, Rabold Erica, Barbieri Ashley N, Baldwin Nancy, Steen Virginia D
Division of Pulmonary and Critical Care Medicine, Allegheny General Hospital, Pittsburgh, PA, USA.
Scleroderma Foundation, Danvers, MA, USA.
Clin Med Insights Circ Respir Pulm Med. 2020 Mar 18;14:1179548420913281. doi: 10.1177/1179548420913281. eCollection 2020.
Systemic sclerosis-associated interstitial lung disease is challenging to diagnose and treat. Patients and physicians can perceive the disease differently and have different views on its management. Communication issues between them can lead to suboptimal disease management. Despite a clear need for improvement in the speed and accuracy of the diagnostic workup, the heterogeneity of clinical symptoms renders the process long and challenging. When considering treatment options, physicians may be more focused on the evidence supporting a particular treatment or on a patient's pulmonary function test results, as opposed to the realities of the patient's difficulties with symptoms or the psychosocial effects of systemic sclerosis-associated interstitial lung disease. Disease management plans should be determined by the patient's own preferences and goals as well as the objective clinical situation. Health care providers must consider their patients as partners on a journey in which treatment decisions are reached jointly. This review will focus on the perspectives of physicians and patients in relation to the diagnosis and management of systemic sclerosis-associated interstitial lung disease. Similarities and differences in these perspectives will be identified, and strategies for achieving optimal disease management will be proposed.
系统性硬化症相关间质性肺病的诊断和治疗具有挑战性。患者和医生对该疾病的认知可能不同,对其管理也有不同的看法。他们之间的沟通问题可能导致疾病管理效果欠佳。尽管明显需要提高诊断检查的速度和准确性,但临床症状的异质性使得这个过程漫长且具有挑战性。在考虑治疗方案时,医生可能更关注支持特定治疗的证据或患者的肺功能测试结果,而不是患者症状方面的实际困难或系统性硬化症相关间质性肺病的社会心理影响。疾病管理计划应由患者自己的偏好和目标以及客观临床情况来决定。医疗保健提供者必须将患者视为共同参与治疗决策过程的伙伴。本综述将聚焦医生和患者在系统性硬化症相关间质性肺病诊断和管理方面的观点。将识别这些观点中的异同,并提出实现最佳疾病管理的策略。