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慢性髓性白血病患者管理的多学科方法分析

Analysis of the multidisciplinary approach for the management of patients affected by chronic myeloid leukaemia.

作者信息

Basile Michele, Di Brino Eugenio, Rumi Filippo, Palmeri Marco, Cicchetti Americo

机构信息

Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Integr Healthc J. 2022 Oct 25;4(1):e000057. doi: 10.1136/ihj-2020-000057. eCollection 2022.

Abstract

BACKGROUND

Chronic myelogenous leukaemia (CML) is a pathological clinical condition with a yearly incidence between 10 and 15 cases per million people, 14 in Italy. Its incidence increases with age, reaching 20-25 yearly cases per million individuals in people over 70 years. A growing importance has been given to the need of a multidisciplinary approach (MDA) for the management of patients with CML.

OBJECTIVE

To analyse the importance of MDA as compared with the current Italian standard of care for the management of CML patients based on the involvement of several health professional figures.

METHODS

A group of healthcare professionals from several healthcare structures were gathered in a first Advisory Board (AB) and divided into as many groups as the number of belonging health structures representative of the Italian provision of therapeutic approaches for CML. In a second AB, the results were validated by the same panel of experts.

RESULTS

The number of dedicated health professionals within the dedicated ward ranged from 1 to 13. Most structures rely on several professionals intervening only in case of necessity. Only one centre provides a booking service based on clinical needs to avoid waiting times. Most centres report there is basically no disagreement in the definition of the clinical pathway and there is a high adherence to national and international CML guidelines.

CONCLUSIONS

The development of forms of interorganisational and interprofessional coordination to improve the diagnosis and the treatment of CML patients have been for long on the agenda of policy makers, managers and professionals for more than 20 years. This analysis represents a starting reference to consider for the evaluation of an MDA in the Italian context.

摘要

背景

慢性粒细胞白血病(CML)是一种临床病理状况,年发病率为每百万人10至15例,在意大利为14例。其发病率随年龄增长而增加,70岁以上人群中每年每百万人有20 - 25例。对于慢性粒细胞白血病患者的管理,多学科方法(MDA)的需求日益受到重视。

目的

基于多个医疗专业人员的参与,分析多学科方法与意大利当前慢性粒细胞白血病患者管理护理标准相比的重要性。

方法

来自多个医疗机构的一组医疗专业人员聚集在第一次咨询委员会(AB)中,并按照代表意大利慢性粒细胞白血病治疗方法提供情况的所属医疗机构数量分成同样多的小组。在第二次咨询委员会中,由同一组专家对结果进行验证。

结果

专门病房内专职医疗专业人员的数量从1到13不等。大多数机构依赖多名专业人员仅在必要时进行干预。只有一个中心根据临床需求提供预约服务以避免等待时间。大多数中心报告称,在临床路径的定义上基本没有分歧,并且对国家和国际慢性粒细胞白血病指南的依从性很高。

结论

20多年来,发展组织间和专业间协调形式以改善慢性粒细胞白血病患者的诊断和治疗一直是政策制定者、管理人员和专业人员议程上的重要事项。该分析是在意大利背景下评估多学科方法时可考虑的一个起始参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ed8/10327453/0e333450df90/ihj-2020-000057f01.jpg

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