新冠疫情对欧洲重症哮喘护理的影响：护理会就此发生永久性改变吗？
The effect of the COVID-19 pandemic on severe asthma care in Europe: will care change for good?
作者信息
Eger Katrien, Paroczai Dora, Bacon Alison, Schleich Florence, Sergejeva Svetlana, Bourdin Arnaud, Vachier Isabelle, Zervas Eleftherios, Katsoulis Konstantinos, Papapetrou Dimosthenis, Kostikas Konstantinos, Csoma Zsuzsanna, Heffler Enrico, Canonica Giorgio Walter, Grisle Ineta, Bieksiene Kristina, Palacionyte Jolita, Ten Brinke Anneke, Hashimoto Simone, Smeenk Frank W J M, Braunstahl Gert-Jan, van der Sar Simone, Mihălţan Florin, Nenasheva Natalia, Peredelskaya Marina, Zvezdin Biljana, Čekerevac Ivan, Hromiš Sanja, Ćupurdija Vojislav, Lazic Zorica, Milenkovic Branislava, Dimic-Janjic Sanja, Yasinska Valentyna, Dahlén Barbro, Bossios Apostolos, Lazarinis Nikolaos, Aronsson David, Egesten Arne, Munir Abul Kashem Mohammad, Ahlbeck Lars, Janson Christer, Škrgat Sabina, Edelbaher Natalija, Leuppi Joerg, Jaun Fabienne, Rüdiger Jochen, Pavlov Nikolay, Gianella Pietro, Fischer Reta, Charbonnier Florian, Chaudhuri Rekha, Smith Steven James, Doe Simon, Fawdon Michelle, Masoli Matthew, Heaney Liam, Haitchi Hans Michael, Kurukulaaratchy Ramesh, Fulton Olivia, Frankemölle Betty, Gibson Toni, Needham Karen, Howarth Peter, Djukanovic Ratko, Bel Elisabeth, Hyland Michael
机构信息
Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Co-first authors.
出版信息
ERJ Open Res. 2022 May 16;8(2). doi: 10.1183/23120541.00065-2022. eCollection 2022 Apr.
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care.
METHODS
In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021.
RESULTS
1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%).
CONCLUSIONS
Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.
背景
2019年冠状病毒病（COVID-19）大流行给医疗服务带来了压力，迫使传统护理路径进行重组。我们调查了欧洲负责重症哮喘患者护理的医生如何重新组织护理，以及这些变化如何影响患者满意度、哮喘控制和未来护理。
方法
在这项全欧洲的横断面研究中，于2020年11月至2021年5月期间，向被医生诊断为重症哮喘的患者发送了患者调查问卷，并向重症哮喘专家发送了医生调查问卷。
结果
来自16个欧洲国家的1101名患者和268名医生参与了该研究。医生报告的重症哮喘护理的常见变化包括使用视频/电话咨询（46%）、医生可及性降低（43%）以及改为居家使用生物制剂（38%）。45%的患者报告改为电话/视频咨询，其中79%对这一变化感到满意或非常满意。在709名使用生物制剂的患者中，24%的患者生物制剂护理发生了变化，其中92%改为居家使用生物制剂，这些患者中有62%对这一变化感到满意或非常满意。只有2%的患者报告生物制剂护理变化与哮喘症状恶化有关。许多医生预计视频/电话咨询（41%）和生物制剂居家使用（52%）将继续实施。
结论
在COVID-19大流行期间，重症哮喘护理改为视频/电话咨询和生物制剂居家使用很常见，且在大多数但并非所有情况下都与高满意度相关。许多医生预计这些变化在未来的重症哮喘护理中仍将持续，不过大流行后满意度水平可能会发生变化。
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