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建立埃勒斯-当洛综合征诊所:经验教训

Establishing an Ehlers-Danlos Syndrome Clinic: Lessons Learned.

作者信息

Knight Dacre R T, Confiado Sunnie M, Bruno Katelyn A, Fairweather DeLisa, Seymour-Sonnier Andrea M, Jain Angita, Gehin Jessica M, Whelan Emily R, Culberson Joshua H, Munipalli Bala, Dawson Nancy L, Rozen Todd D, Wick Joseph J, Kotha Archana

机构信息

Department of General Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA.

Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL USA.

出版信息

SN Compr Clin Med. 2022;4(1):138. doi: 10.1007/s42399-022-01218-w. Epub 2022 Jul 5.

Abstract

In a large academic medical center, patient requests from the community and internal referrals for evaluation of suspected hypermobility conditions were being denied consultation because services specific to this condition were not available. We identified this gap and developed a comprehensive evaluation for this unique patient population. The objective of this paper is to demonstrate a solution for improving outcomes in a neglected patient population by establishing an innovative outpatient clinic specifically tailored for patients with EDS. We describe the lessons learned on establishing a specialty clinic for treating patients with hypermobility syndromes including hypermobile Ehlers-Danlos syndrome () and hypermobile syndrome disorder (). Findings were collected from a patient focus group that was instrumental in understanding common care gaps. We document the firsthand perspective of three patients presenting with hypermobility accompanied by joint pain and denote the complicated state of healthcare in recognizing and treating this condition. A summary of patient demographics and characteristics was collected from patients seen in the clinic from November 14, 2019 to April 13, 2021. The firsthand accounts illustrate the challenges faced in treating this condition and the need for, and success of, this clinic using a coordinated care model. Demographics reveal a primarily white female population under the age of 50 with many comorbidities. Genetic testing was largely negative, with more patients diagnosed with HSD than hEDS. Our shared experience of launching a successful EDS clinic may assist other clinicians in establishing similar care models.

摘要

在一家大型学术医疗中心,来自社区的患者请求以及内部转诊对疑似关节过度活动症的评估都被拒绝会诊,因为没有针对这种病症的特定服务。我们发现了这一差距,并为这一独特的患者群体制定了全面评估方案。本文的目的是通过建立一个专门为患有埃勒斯-当洛综合征(EDS)患者量身定制的创新门诊诊所,来展示一种改善被忽视患者群体治疗效果的解决方案。我们描述了在建立一个治疗关节过度活动综合征患者(包括关节过度活动型埃勒斯-当洛综合征(hEDS)和关节过度活动综合征障碍(HSD))的专科诊所过程中所学到的经验教训。从一个对了解常见护理差距有很大帮助的患者焦点小组收集了相关发现。我们记录了三名有关节过度活动并伴有关节疼痛患者的第一手观点,并指出了在识别和治疗这种病症时医疗保健的复杂状况。从2019年11月14日至2021年4月13日在该诊所就诊的患者中收集了患者人口统计学和特征的摘要。这些第一手记录说明了治疗这种病症所面临的挑战,以及使用协调护理模式设立该诊所的必要性和成效。人口统计学显示,主要是50岁以下患有多种合并症的白人女性群体。基因检测大多为阴性,被诊断患有HSD的患者比hEDS患者更多。我们成功开办EDS诊所的共同经验可能会帮助其他临床医生建立类似的护理模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a4/9256574/9e5181ac41e1/42399_2022_1218_Fig1_HTML.jpg

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