Figueiredo Francisco C, Baudouin Christophe, Rolando Maurizio, Messmer Elisabeth M, van Setten Gysbert, Garrigue Jean-Sébastien, Garrigos Genevieve, Labetoulle Marc
Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, Newcastle upon Tyne, UK.
Bioscience Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Ophthalmol Ther. 2021 Jun;10(2):321-335. doi: 10.1007/s40123-021-00341-6. Epub 2021 Apr 1.
Previous studies have examined the patient experience regarding the diagnosis and management of dry eye disease (DED). The current study explored the ways in which the DED diagnostic pathway differs for those living with and without Sjögren's syndrome (SS), to identify aspects that influence the patient experience and associated quality of life (QoL).
An observational/descriptive, non-interventional, retrospective, self-reported online survey was conducted among adults living in France, Spain and Italy who were diagnosed with DED (with/without SS), were using topical DED treatments (≥ 6 months), and were not contact lens users. Recruitment was via an online database for non-SS participants and through local patient advocacy groups for SS respondents.
The analysis included 827 respondents; 416 (50.3%) had SS and 82% were female. The mean age was 55 (SD 11; range 16-99) years. The mean age at diagnosis was 46 (SD 12; range 13-78) years and 50 (SD 10; range 21-73) years for SS and non-SS groups, respectively (p < 0.0001). The mean time to diagnosis was extended for SS participants [32 (SD 62) months] versus non-SS individuals [8.6 (SD 28) months (p < 0.0001)] and was associated with reduced QoL scores (r = 0.113; p = 0.0169). More SS participants (31%) consulted ≥ 4 healthcare professionals (HCPs) before DED diagnosis, versus non-SS individuals (6%) (p < 0.0001). Diagnosing clinician varied for SS respondents according to country, probably due to differences in healthcare systems/structures. More SS participants viewed their condition as a handicap than a discomfort, reporting greater QoL impact (p < 0.0001).
Patient experiences in DED diagnosis vary substantially when comparing SS and non-SS individuals. Time to diagnosis significantly impacts QoL for SS patients, who see more HCPs ahead of DED diagnosis. The number of HCPs consulted before diagnosis and perceptions of DED are important for both groups. Country-specific variations highlight opportunities to improve consistency and efficiency across DED diagnostic pathways. These data should be considered alongside existing evidence from high-quality sources (e.g. clinical records).
以往的研究探讨了患者在干眼症(DED)诊断和管理方面的体验。本研究探讨了患有和未患有干燥综合征(SS)的患者在DED诊断途径上的差异,以确定影响患者体验和相关生活质量(QoL)的因素。
对居住在法国、西班牙和意大利的成年人进行了一项观察性/描述性、非干预性、回顾性、自我报告的在线调查,这些成年人被诊断患有DED(有/无SS),正在使用局部DED治疗(≥6个月),且不是隐形眼镜使用者。非SS参与者通过在线数据库招募,SS受访者通过当地患者倡导组织招募。
分析包括827名受访者;416名(50.3%)患有SS,82%为女性。平均年龄为55岁(标准差11;范围16 - 99岁)。SS组和非SS组的诊断平均年龄分别为46岁(标准差12;范围13 - 78岁)和50岁(标准差10;范围21 - 73岁)(p < 0.0001)。SS参与者的平均诊断时间延长[32(标准差62)个月],而非SS个体为[8.6(标准差28)个月(p < 0.0001)],且与生活质量得分降低相关(r = 0.113;p = 0.0169)。更多的SS参与者(31%)在DED诊断前咨询了≥4名医疗保健专业人员(HCPs),而非SS个体为(6%)(p < 0.0001)。根据国家不同(可能由于医疗保健系统/结构的差异),SS受访者的诊断医生也有所不同。更多的SS参与者将他们的病情视为一种残疾而非不适,报告对生活质量的影响更大(p < 0.0001)。
比较SS和非SS个体时,DED诊断中的患者体验存在显著差异。诊断时间对SS患者的生活质量有显著影响,他们在DED诊断前咨询的HCPs更多。两组在诊断前咨询的HCPs数量以及对DED的认知都很重要。特定国家的差异凸显了改善DED诊断途径的一致性和效率的机会。这些数据应与来自高质量来源(如临床记录)的现有证据一并考虑。