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[多学科性是成功的关键:皮肤科与风湿病科合作以优化患者护理]

[Multidisciplinarity as the key to success : Cooperation between dermatology and rheumatology to optimize patient care].

作者信息

Staubach Petra, Veelen Katrin, Zimmer Sebastian, Sohn Anna, Lang Berenice M, Peveling-Oberhag Adriane, Grabbe Stephan, Kaluza-Schilling Wiebke, Schwarting Andreas, Wegner Joanna

机构信息

Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.

Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland.

出版信息

Dermatologie (Heidelb). 2022 Nov;73(11):866-871. doi: 10.1007/s00105-022-05051-z. Epub 2022 Sep 7.

DOI:10.1007/s00105-022-05051-z
PMID:36069996
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9592635/
Abstract

BACKGROUND

Treatment of patients with systemic autoimmune and/or autoinflammatory diseases (AI/AInf) often requires multidisciplinary collaboration of various medical specialties.

OBJECTIVES

We evaluated whether the establishment of a multidisciplinary board, which we termed rheuma board (RB), can contribute to optimization of care for patients with psoriatic arthritis (PsA) or other AI/AInf.

MATERIALS AND METHODS

A total of 272 patients were included in the study. Patients were divided into three groups-group 1: 41 patients with or with suspected PsA, initially assessed in the dermatology department and afterwards presented for consultation in the rheumatology department; group 2: 166 patients with or with suspected PsA presenting in the dermatology department and afterwards discussed by RB; group 3: 65 patients with other AI/AInf presenting in the dermatology department and afterwards discussed by RB. We evaluated the average duration from initial presentation to therapy initiation after completing evaluation and diagnostics by both specialties. In addition, diagnosis confirmation/verification and therapy continuation/optimization were analyzed for all three groups.

RESULTS

The average duration from initial presentation until therapy initiation was 85 ± 42.24 (5-173) days in group 1, 15 ± 13.09 (0-78) days in group 2, and 20 ± 16.71 (1-75) days in group 3. In addition, in groups 2 and 3 confirmation of diagnosis was faster and waiting time for diagnosis and therapy initiation was significantly reduced.

CONCLUSIONS

Establishment of a RB results in a significant reduction in the time duration between first presentation and initiation of therapy, and an improvement of care for patients with AI/AInf including confirmation of diagnosis and therapy optimization.

摘要

背景

系统性自身免疫性和/或自身炎症性疾病(AI/AInf)患者的治疗通常需要多个医学专科的多学科协作。

目的

我们评估了一个我们称为风湿病委员会(RB)的多学科委员会的设立是否有助于优化银屑病关节炎(PsA)或其他AI/AInf患者的护理。

材料与方法

共有272例患者纳入本研究。患者分为三组:第1组:41例患有或疑似患有PsA的患者,最初在皮肤科进行评估,随后到风湿科进行会诊;第2组:166例患有或疑似患有PsA的患者在皮肤科就诊,随后由RB进行讨论;第3组:65例患有其他AI/AInf的患者在皮肤科就诊,随后由RB进行讨论。我们评估了两个专科完成评估和诊断后从首次就诊到开始治疗的平均持续时间。此外,对所有三组的诊断确认/核实以及治疗的持续/优化情况进行了分析。

结果

第1组从首次就诊到开始治疗的平均持续时间为85±42.24(5 - 173)天,第2组为15±13.09(0 - 78)天,第3组为20±16.71(1 - 75)天。此外,在第2组和第3组中,诊断确认更快,诊断和开始治疗的等待时间显著缩短。

结论

RB的设立显著缩短了首次就诊与开始治疗之间的时间间隔,并改善了AI/AInf患者的护理,包括诊断确认和治疗优化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/a91a3b47c70b/105_2022_5051_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/47658ab7931f/105_2022_5051_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/a6fb06101a10/105_2022_5051_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/d323daee204f/105_2022_5051_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/a91a3b47c70b/105_2022_5051_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/47658ab7931f/105_2022_5051_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/a6fb06101a10/105_2022_5051_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/d323daee204f/105_2022_5051_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dad3/9592635/a91a3b47c70b/105_2022_5051_Fig4_HTML.jpg

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