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共识文件:溃疡性结肠炎患者的管理偏好:需要考虑的要点和建议。

Consensus document on the management preferences of patients with ulcerative colitis: points to consider and recommendations.

机构信息

Unidad de Atención Crohn-colitis, Servicio de Aparato Digestivo, Hospital Universitari Vall d'Hebron, Barcelona.

Servicio Digestivo, Hospital Universitario Son Espases, Palma de Mallorca.

出版信息

Eur J Gastroenterol Hepatol. 2020 Dec;32(12):1514-1522. doi: 10.1097/MEG.0000000000001885.

Abstract

BACKGROUND AND AIMS

Our objective was to define, describe and organize (on the basis of consensus) the patient's preferences in the management of ulcerative colitis (UC), in order to further incorporate them in daily practice and improve patients satisfaction, adherence to the treatment and quality of care.

METHODS

Qualitative study. A narrative literature review in Medline using Mesh and free-text terms was conducted to identify articles on UC patient preferences as well as clinical scenarios that may influence the preferences. The results were presented and discussed in a multidisciplinary nominal group meeting composed of six gastroenterologists, one primary care physician, one nurse practitioner and one expert patient. Key clinical scenarios and patient preferences were then defined, generating a series of points to consider and recommendations. The level of agreement with the final selection of preferences was established following a Delphi process.

RESULTS

The narrative review retrieved 69 articles of qualitative design and moderate quality. The following key clinical scenarios were identified: diagnosis, follow-up, surgery, and special situations/patients profiles such as adolescents or women. Patient preferences were classified into information, treatment (pharmacological and non-pharmacological), follow-up, relations with health professionals, relations with the health system and administration. Finally, 11 recommendations on patient preferences for UC in relation to its management reached the level of agreement established.

CONCLUSION

The consensual description of patient's preferences contribute to identify different areas for improvement in healthcare practice.

摘要

背景和目的

我们的目标是定义、描述和组织(基于共识)溃疡性结肠炎(UC)患者的治疗偏好,以便进一步将其纳入日常实践中,提高患者的满意度、治疗依从性和护理质量。

方法

定性研究。在 Medline 中使用 Mesh 和自由文本术语进行了叙述性文献复习,以确定关于 UC 患者偏好以及可能影响偏好的临床情况的文章。结果在由六名胃肠病学家、一名初级保健医生、一名执业护士和一名专家患者组成的多学科名义小组会议上进行了介绍和讨论。然后定义了关键的临床情况和患者偏好,生成了一系列需要考虑的要点和建议。最后通过 Delphi 流程确定对偏好最终选择的一致性程度。

结果

叙述性综述检索到 69 篇定性设计的文章,质量中等。确定了以下关键临床情况:诊断、随访、手术以及特殊情况/患者特征,如青少年或女性。患者偏好分为信息、治疗(药物和非药物)、随访、与卫生专业人员的关系、与卫生系统和管理的关系。最后,就 UC 管理相关的患者偏好达成了 11 项共识建议。

结论

对患者偏好的共识描述有助于确定医疗实践中需要改进的不同领域。

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