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西班牙常规临床实践中庞贝病管理情况调查。

Survey on the management of Pompe disease in routine clinical practice in Spain.

机构信息

Neuromuscular Unit, Neurology Department, Hospital Universitario 12 de Octubre, imas12 Research Institute, Biomedical Network Research Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Av. de Córdoba, s/n, 28041, Madrid, Spain.

Neurology Department, Hospital General Universitario de Alicante Doctor Balmis, Instituto de Investigación Biosanitaria de Alicante (ISABIAL), Alicante, Spain.

出版信息

Orphanet J Rare Dis. 2022 Dec 5;17(1):426. doi: 10.1186/s13023-022-02574-5.

Abstract

BACKGROUND

Despite the availability of several clinical guidelines, not all health professionals use their recommendations to manage patients with Pompe disease, a rare genetic disorder involving high-impact therapy. Through several discussion meetings and a survey, the present study aimed to learn about the management of Pompe disease in routine clinical practice in Spain, to improve clinical care in a real-life situation.

RESULTS

The survey was sent to 42 healthcare professionals who manage patients with Pompe disease in their clinical practice. Although most respondents followed the clinical guidelines, clinical practice differed from the expert recommendations in many cases. Approximately 7% did not request a genetic study to confirm the diagnosis before starting treatment, and 21% considered that only two dried blood spot determinations suffice to establish the diagnosis. About 76% requested anti-GAA antibodies when there is a suspicion of lack of treatment efficacy, though a significant percentage of respondents have never requested such antibodies. According to 31% of the respondents, significant impairment of motor function and/or respiratory insufficiency is a requirement for authorizing medication at their hospital. Up to 26% waited for improvements over the clinical follow-up to maintain treatment and withdrew it in the absence of improvement since they did not consider disease stabilization to be a satisfactory outcome.

CONCLUSIONS

The results highlight the lack of experience and/or knowledge of some professionals caring for patients with Pompe disease. It is necessary to develop and disseminate simple guidelines that help to apply the expert recommendations better or centralize patient follow-up in highly specialized centers.

摘要

背景

尽管有多个临床指南可用,但并非所有卫生专业人员都将其建议用于管理庞贝病患者,这种罕见的遗传性疾病需要采用高影响的治疗方法。通过多次讨论会议和一项调查,本研究旨在了解西班牙常规临床实践中庞贝病的管理情况,以改善实际情况下的临床护理。

结果

该调查发送给了 42 名在临床实践中管理庞贝病患者的医疗保健专业人员。尽管大多数受访者遵循了临床指南,但在许多情况下,临床实践与专家建议有所不同。约 7%的人在开始治疗前未请求进行基因研究以确认诊断,而 21%的人认为仅进行两次干血斑测定即可确诊。约 76%的人在怀疑治疗效果不佳时会要求检测抗 GAA 抗体,但有相当一部分受访者从未要求过这种抗体。根据 31%的受访者的意见,只有当存在运动功能显著受损和/或呼吸功能不全时,他们所在的医院才会批准用药。多达 26%的人在缺乏改善的情况下等待临床随访以维持治疗,并在没有改善的情况下停药,因为他们不认为疾病稳定是一个满意的结果。

结论

结果突出了一些照顾庞贝病患者的专业人员缺乏经验和/或知识。有必要制定和传播简单的指南,以帮助更好地应用专家建议,或在高度专业化的中心集中患者随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c13d/9724265/7b90276026b4/13023_2022_2574_Fig1_HTML.jpg

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