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2022年欧洲抗风湿病联盟关于风湿性和肌肉骨骼疾病远程护理的考虑要点

2022 EULAR points to consider for remote care in rheumatic and musculoskeletal diseases.

作者信息

de Thurah Annette, Bosch Philipp, Marques Andrea, Meissner Yvette, Mukhtyar Chetan B, Knitza Johannes, Najm Aurélie, Østerås Nina, Pelle Tim, Knudsen Line Raunsbæk, Šmucrová Hana, Berenbaum Francis, Jani Meghna, Geenen Rinie, Krusche Martin, Pchelnikova Polina, de Souza Savia, Badreh Sara, Wiek Dieter, Piantoni Silvia, Gwinnutt James M, Duftner Christina, Canhão Helena M, Quartuccio Luca, Stoilov Nikolay, Prior Yeliz, Bijlsma Johannes Wj, Zabotti Alen, Stamm Tanja A, Dejaco Christian

机构信息

Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Ann Rheum Dis. 2022 Aug;81(8):1065-1071. doi: 10.1136/annrheumdis-2022-222341. Epub 2022 Apr 25.

Abstract

BACKGROUND

Remote care and telehealth have the potential to expand healthcare access, and the COVID-19 pandemic has called for alternative solutions to conventional face-to-face follow-up and monitoring. However, guidance is needed on the integration of telehealth into clinical care of people with rheumatic and musculoskeletal diseases (RMD).

OBJECTIVE

To develop EULAR points to consider (PtC) for the development, prioritisation and implementation of telehealth for people with RMD.

METHODS

A multidisciplinary EULAR task force (TF) of 30 members from 14 European countries was established, and the EULAR standardised operating procedures for development of PtC were followed. A systematic literature review was conducted to support the TF in formulating the PtC. The level of agreement among the TF was established by anonymous online voting.

RESULTS

Four overarching principles and nine PtC were formulated. The use of telehealth should be tailored to patient's needs and preferences. The healthcare team should have adequate equipment and training and have telecommunication skills. Telehealth can be used in screening for RMD as preassessment in the referral process, for disease monitoring and regulation of medication dosages and in some non-pharmacological interventions. People with RMD should be offered training in using telehealth, and barriers should be resolved whenever possible.The level of agreement to each statement ranged from 8.5 to 9.8/10.

CONCLUSION

The PtC have identified areas where telehealth could improve quality of care and increase healthcare access. Knowing about drivers and barriers of telehealth is a prerequisite to successfully establish remote care approaches in rheumatologic clinical practice.

摘要

背景

远程护理和远程医疗有潜力扩大医疗服务的可及性,而新冠疫情促使人们寻求传统面对面随访和监测的替代解决方案。然而,将远程医疗整合到风湿性和肌肉骨骼疾病(RMD)患者的临床护理中需要相关指导。

目的

制定欧洲抗风湿病联盟(EULAR)关于RMD患者远程医疗的开发、优先级确定及实施的要点考虑(PtC)。

方法

成立了一个由来自14个欧洲国家的30名成员组成的多学科EULAR特别工作组(TF),并遵循EULAR制定PtC的标准化操作程序。进行了系统的文献综述以支持TF制定PtC。通过匿名在线投票确定TF成员之间的共识水平。

结果

制定了四项总体原则和九条PtC。远程医疗的使用应根据患者的需求和偏好进行调整。医疗团队应具备足够的设备和培训,并掌握电信技能。远程医疗可用于RMD的筛查,作为转诊过程中的预评估、疾病监测、药物剂量调整以及一些非药物干预。应为RMD患者提供使用远程医疗的培训,并尽可能消除障碍。对每条陈述的共识水平在8.5至9.8/10之间。

结论

PtC确定了远程医疗可改善护理质量并增加医疗服务可及性的领域。了解远程医疗的驱动因素和障碍是在风湿病临床实践中成功建立远程护理方法的先决条件。

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