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收集患者和风湿病学家的意见,以改善特发性炎性肌病的治疗效果。

Gathering patients and rheumatologists' perceptions to improve outcomes in idiopathic inflammatory myopathies.

机构信息

Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.

Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2022 Apr 11;77:100031. doi: 10.1016/j.clinsp.2022.100031. eCollection 2022.

Abstract

OBJECTIVE

Therapeutic targets in Idiopathic Inflammatory Myopathies (IIM) are based on the opinions of physicians/specialists, which may not reflect the main concerns of patients. The authors, therefore, assessed the outcome concerns of patients with IIM and compared them with the concerns of rheumatologists in order to develop an IIM outcome standard set.

METHODS

Ninety-three IIM patients, 51 rheumatologists, and one physiotherapist were invited to participate. An open questionnaire was initially applied. The top 10 answers were selected and applied in a multiple-choice questionnaire, inquiring about the top 3 major concerns. Answers were compared, and the agreement rate was calculated. Concerns were gathered in an IIM outcome standard set with validated measures.

RESULTS

The top three outcome concerns raised by patients were medication side effects/muscle weakness/prevention functionality loss. The top three concerns among rheumatologists were to prevent loss of functionality/to ensure the quality of life/to achieve disease remission. Other's outcomes concerns only pointed out by patients were muscle pain/diffuse pain/skin lesions/fatigue. The agreement rate between both groups was 41%. Assessment of these parameters guided the development of an IIM standard set which included Myositis Disease Activity Assessment Visual Analogue Scale/Manual Muscle Testing/fatigue and pain Global Visual Analogue Scale/Health Assessment Questionnaire/level of physical activity.

CONCLUSION

The authors propose a novel standard set to be pursued in IIM routine follow-up, which includes not only the main patients/rheumatologist outcome concerns but also additional important outcomes only indicated by patients. Future studies are necessary to confirm if this comprehensive approach will result in improved adherence and ultimately in better assistance.

摘要

目的

特发性炎性肌病(IIM)的治疗靶点基于医生/专家的意见,这可能无法反映患者的主要关注点。因此,作者评估了 IIM 患者的结局关注点,并将其与风湿病学家的关注点进行了比较,以制定 IIM 结局标准集。

方法

邀请了 93 名 IIM 患者、51 名风湿病学家和 1 名物理治疗师参与。最初应用了开放式问卷。选择了前 10 个答案,并在多项选择问卷中应用,询问了前 3 个主要关注点。比较了答案,并计算了一致率。将关注点汇总到一个具有验证措施的 IIM 结局标准集中。

结果

患者提出的前三个结局关注点是药物副作用/肌肉无力/预防功能丧失。风湿病学家的前三个关注点是预防功能丧失/确保生活质量/实现疾病缓解。其他仅由患者指出的关注点是肌肉疼痛/弥漫性疼痛/皮肤损伤/疲劳。两组之间的一致率为 41%。这些参数的评估指导了 IIM 标准集的制定,其中包括肌炎疾病活动评估视觉模拟量表/手动肌肉测试/疲劳和疼痛整体视觉模拟量表/健康评估问卷/体力活动水平。

结论

作者提出了一个新的标准集,用于 IIM 常规随访,其中不仅包括主要患者/风湿病学家的结局关注点,还包括仅由患者指出的其他重要结局。需要进一步的研究来确认这种全面的方法是否会提高依从性,并最终提供更好的帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f17/9020087/346878485631/gr1.jpg

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