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三级转诊中心的非感染性葡萄膜炎多学科诊所:临床影响与附加价值

A Non-Infectious Uveitis Multidisciplinary Clinic in a Tertiary Referral Center: Clinical Impact and Added Value.

作者信息

Leal Inês, Romão Vasco C, Mano Sofia, Khmelinskii Nikita, Campanilho-Marques Raquel, Ponte Cristina, Macieira Carla, Oliveira-Ramos Filipa, Vieira-Sousa Elsa, Rosa Carlos Miranda, Rodrigues Walter, Abegão Pinto Luís, Marques-Neves Carlos, Fonseca João Eurico

机构信息

Ophthalmology Department, Hospital de Santa Maria, Centro Hospitalar Univeristário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

Centro de Estudos das Ciências da Visão, Clínica Universitária de Oftalmologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

出版信息

J Multidiscip Healthc. 2021 Mar 22;14:695-704. doi: 10.2147/JMDH.S292981. eCollection 2021.

Abstract

Non-infectious uveitis (NIU) is a group of sight-threatening diseases that generates significant burden for the healthcare systems due to its adverse outcomes, irreversible structural complications in the eye with loss of visual function, limited clinical expertise and low-grade evidence for best practice. The usefulness of multidisciplinary care, specifically close collaboration between Rheumatologists and Ophthalmologists in NIU, has been emphasized in the literature. In this paper, the assessment tools and protocols used in our clinic are depicted and an overview of our activity with a brief description of the patients included in our registry, between 2018 and 2020 is provided. The cohort of 290 patients assessed in our NIU clinic, their demographics, sources of referral, details about immunosuppression treatment, and internal and external collaborations is described. This experience-based manuscript aims to describe the general functioning of our multidisciplinary NIU clinic, highlighting the benefits and drawbacks of multidisciplinary team management in patients with NIU, ultimately initiating a dialogue on what an NIU clinic should be and providing information for newly NIU clinics start-up. In conclusion, establishing a standardized and multidisciplinary clinic in NIU allows to systematically observe and follow-up this infrequent disease at a tertiary hospital level, thus improving quality of care delivery and research avenues.

摘要

非感染性葡萄膜炎(NIU)是一组威胁视力的疾病,因其不良后果、眼部不可逆的结构并发症导致视力功能丧失、临床专业知识有限以及最佳实践的证据不足,给医疗系统带来了巨大负担。文献中强调了多学科护理的作用,特别是在NIU中风湿病学家和眼科医生之间的密切合作。本文描述了我们诊所使用的评估工具和方案,并概述了我们在2018年至2020年期间的活动,简要介绍了纳入我们登记册的患者情况。描述了在我们的NIU诊所评估的290名患者的队列、他们的人口统计学特征、转诊来源、免疫抑制治疗细节以及内部和外部合作情况。这份基于经验的手稿旨在描述我们多学科NIU诊所的一般运作情况,突出NIU患者多学科团队管理的利弊,最终引发关于NIU诊所应该是什么样的讨论,并为新成立的NIU诊所提供信息。总之,在NIU中建立一个标准化的多学科诊所能够在三级医院层面系统地观察和随访这种罕见疾病,从而提高护理质量和研究途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbef/7997415/dc69d3e35d90/JMDH-14-695-g0001.jpg

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