Farina Nicola, Benanti Giovanni, De Luca Giacomo, Palmisano Anna, Peretto Giovanni, Tomassetti Sara, Giorgione Veronica, Forma Ornella, Esposito Antonio, Danese Silvio, Dagna Lorenzo, Matucci-Cerinic Marco, Campochiaro Corrado
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
J Multidiscip Healthc. 2022 Apr 20;15:815-824. doi: 10.2147/JMDH.S295478. eCollection 2022.
Systemic sclerosis (SSc) is a rare connective tissue disease characterised by immune dysfunction, vascular damage and fibrosis affecting the skin and multiple internal organs. The clinical spectrum of SSc is wide and its manifestations may lead to severe morbidity and mortality, in addition to a great impact on patients' quality of life. Due to the multifaceted clinical manifestations of SSc, its management requires a combined expertise of different medical specialists to guarantee an adequate disease control and prevent organ complications. Multi-disciplinary teams (MDT), which are composed by physicians and other specialized health professionals, represent therefore a key element for the comprehensive management of SSc patients. Moreover, MTD can improve communication and patients' empowerment while the presence of dedicated nurses can help patients to ask questions about their condition. The scope of this narrative review is to analyse the available evidences regarding the role of MDT in the management of SSc patients, and how this holistic approach may improve different disease domains and the overall prognosis. MDT regarding the cardiovascular and lung complication are the more represented in literature, given the great impact in prognosis. Nonetheless, MDT have been shown to be fundamental also in other disease domains as they can intercept early manifestations, thus stratifying patients based on the individual risks in order to personalize patients' follow-up. MDTs may also minimize the treatment delay, enabling fast-track specialist referral. On the other hand, there are few trials specifically studying MDT in SSc and several authors have highlight the lack of standardization.
系统性硬化症(SSc)是一种罕见的结缔组织疾病,其特征为免疫功能障碍、血管损伤以及影响皮肤和多个内脏器官的纤维化。SSc的临床谱广泛,其表现除了对患者生活质量有重大影响外,还可能导致严重的发病和死亡。由于SSc临床表现的多面性,其管理需要不同医学专家的综合专业知识,以确保对疾病进行充分控制并预防器官并发症。因此,由医生和其他专业健康专家组成的多学科团队(MDT)是全面管理SSc患者的关键要素。此外,多学科团队可以改善沟通并增强患者的自主权,而专门护士的存在可以帮助患者就自身病情提问。本叙述性综述的范围是分析关于多学科团队在SSc患者管理中的作用的现有证据,以及这种整体方法如何改善不同的疾病领域和总体预后。鉴于对预后的重大影响,关于心血管和肺部并发症的多学科团队在文献中出现得较多。尽管如此,多学科团队在其他疾病领域也已被证明是至关重要的,因为它们可以发现早期表现,从而根据个体风险对患者进行分层,以便对患者的随访进行个性化。多学科团队还可以尽量减少治疗延迟,实现快速专科转诊。另一方面,专门研究SSc中多学科团队的试验很少,几位作者强调了缺乏标准化的问题。