De Prins Louise, Raap Ulrike, Mueller Tara, Schmid-Grendelmeier Peter, Haase Christiane H, Backer Vibeke, Fokkens Wytske, Benoist Linda B, Prokopakis Emmanuel, Hopkins Claire, Claeys Nele, Teeling Thijs, Cypers Lindsay, Cools Leen, Bjermer Leif H, Diamant Zuzana, Wahn Ulrich, Scadding Glenis, Bachert Claus, Patel Sunni R, Van Staeyen Elizabeth, Hellings Peter
Department of Otorhinolaryngology, Head and Neck Surgery, Universitair Ziekenhuis Leuven, Leuven, Belgium.
Division of Experimental Allergology and Immunodermatology, University of Oldenburg, Oldenburg, Germany.
Front Allergy. 2022 Jun 2;3:889221. doi: 10.3389/falgy.2022.889221. eCollection 2022.
Type 2 inflammation underlies the chronicity of disease in subgroups of patients with asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and atopic dermatitis (AD), that often co-exist. Although several studies have investigated the unmet needs of asthma, AD and CRSwNP as such, little is known about the similarities and differences in experiences and perspectives of the current management of patients with comorbid Type 2 inflammatory diseases.
To improve insight into the common and organ-specific needs of patients with Type 2 inflammation and comorbidities, allowing the formulation of recommendations to better address these needs in the future.
This qualitative study was conducted between July 2021 and December 2021 using semi-structured face-to-face or telephone interviews with patients suffering from year-long severe chronic Type 2 inflammation and at least one co-morbid inflammatory condition. Seven participating academic centers in Europe interviewed asthma (Copenhagen and Leuven), CRSwNP (London, Amsterdam and Crete) and/or AD (Oldenburg and Zurich) patients on patient characteristics, disease severity, shortcomings of current care pathways and suggestions for improvement of care. Transcripts were analyzed using an inductive thematic analysis approach.
Eighty-one patients with severe Type 2 inflammation and comorbidities were interviewed. Similar needs were recognized by patients with Type 2 inflammation, with both a lack of coordination in care and a lack of a real cure reported as being most frustrating. However, several needs are specific to asthma, CRSwNP and AD. Suggestions for improvement of care were generic across diseases, such as the implementation of a multidisciplinary approach, the improved facilitation of access to better treatments, the increase of general awareness on disease burden, and better educational programs for healthcare providers and patients. Of note, patients with CRSwNP also stated the need for alternatives to sinus surgery, whereas patients with asthma requested better medical care to prevent exacerbations and patients with AD would warmly welcome the reimbursement of emollients.
Patients with asthma, CRSwNP and AD have shared unmet needs that need to be addressed by physicians, the academic community and health policy makers. This survey provides unique recommendations made by patients for the implementation of better care.
2型炎症是哮喘、伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)和特应性皮炎(AD)患者亚组中疾病慢性化的基础,这些疾病常共存。尽管有多项研究分别调查了哮喘、AD和CRSwNP未满足的需求,但对于2型炎症性疾病合并症患者当前治疗的经验和观点的异同知之甚少。
深入了解2型炎症及合并症患者的共同需求和器官特异性需求,以便制定建议,在未来更好地满足这些需求。
这项定性研究于2021年7月至2021年12月期间进行,采用半结构化面对面或电话访谈的方式,访谈患有长达一年的严重慢性2型炎症且至少有一种合并炎症性疾病的患者。欧洲的七个参与学术中心对哮喘患者(哥本哈根和鲁汶)、CRSwNP患者(伦敦、阿姆斯特丹和克里特岛)和/或AD患者(奥尔登堡和苏黎世)进行了访谈,内容涉及患者特征、疾病严重程度、当前治疗途径的不足以及改善治疗的建议。使用归纳主题分析方法对访谈记录进行分析。
共访谈了81例患有严重2型炎症及合并症的患者。2型炎症患者认识到了相似的需求,护理缺乏协调以及没有真正的治愈方法被认为是最令人沮丧的。然而,哮喘、CRSwNP和AD也有一些特定需求。改善治疗的建议在各种疾病中具有普遍性,例如实施多学科方法、更好地促进获得更好的治疗、提高对疾病负担的普遍认识,以及为医疗保健提供者和患者提供更好的教育项目。值得注意的是,CRSwNP患者还表示需要鼻窦手术的替代方法,而哮喘患者要求更好的医疗护理以预防病情加重,AD患者热烈欢迎润肤剂能得到报销。
哮喘、CRSwNP和AD患者有共同的未满足需求,需要医生、学术界和卫生政策制定者加以解决。这项调查提供了患者对实施更好治疗的独特建议。