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遗传性血管性水肿中的医患互动——2019年冠状病毒病大流行的关键经验教训

Patient-physician interactions in hereditary angioedema-Key learnings from the coronavirus disease 2019 pandemic.

作者信息

Maurer Marcus, Buttgereit Thomas, Magerl Markus, Schön Kathrin, Balla Zsusanna, Farkas Henriette

机构信息

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité - Universitätsmedizin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.

出版信息

Clin Transl Allergy. 2023 Sep;13(9):e12300. doi: 10.1002/clt2.12300.

DOI:10.1002/clt2.12300
PMID:37746793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10492262/
Abstract

BACKGROUND

The coronavirus disease pandemic and its containing measures have caused concerns for patients with hereditary angioedema (HAE) and their treating physicians. Both faced challenges surrounding interaction, and communication had to adapt to facilitate appropriate management. Specifically, the pandemic resulted in reduced in-person contact in clinics. Where possible, telemedicine appointments were offered and treatment outside the hospital setting was encouraged. BODY: The pandemic markedly affected patient-physician communication, which is essential to maintain partnerships and optimize care. Although patients with HAE are often experts in their condition, guidance by their physicians is essential, especially with the recent shift toward patient-centered management for rare diseases and shared decision-making (SDM). SDM enables patients to take control of their disease and allows the risks and benefits of treatment to be discussed with their physicians. This review explores perspectives from patients and physicians in the HAE clinical setting, particularly regarding their experiences with communication throughout the pandemic. We discuss the importance of SDM in rare diseases such as HAE, factors that impact effective communication, and potential solutions.

CONCLUSION

Since patient-centered care and SDM have particular relevance in rare diseases in general, we believe our findings could be transferrable and applicable in the management of other rare diseases.

摘要

背景

冠状病毒病大流行及其防控措施引发了遗传性血管性水肿(HAE)患者及其治疗医生的担忧。双方在互动方面都面临挑战,沟通方式必须做出调整以促进恰当的管理。具体而言,大流行导致诊所内面对面接触减少。在可能的情况下,提供了远程医疗预约,并鼓励在院外进行治疗。

正文

大流行显著影响了医患沟通,而这种沟通对于维持合作关系和优化治疗至关重要。尽管HAE患者通常对自身病情很了解,但医生的指导必不可少,尤其是在近期向以患者为中心的罕见病管理和共同决策(SDM)转变的情况下。SDM使患者能够掌控自己的疾病,并能与医生讨论治疗的风险和益处。本综述探讨了HAE临床环境中患者和医生的观点,特别是他们在整个大流行期间的沟通经历。我们讨论了SDM在HAE等罕见病中的重要性、影响有效沟通的因素以及潜在的解决方案。

结论

鉴于以患者为中心的护理和SDM在一般罕见病中具有特殊意义,我们认为我们的研究结果可能具有可转移性,并适用于其他罕见病的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/0d6125971d45/CLT2-13-e12300-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/1120de90a392/CLT2-13-e12300-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/e60ad9d14dcc/CLT2-13-e12300-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/0d6125971d45/CLT2-13-e12300-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/1120de90a392/CLT2-13-e12300-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/e60ad9d14dcc/CLT2-13-e12300-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eef/10492262/0d6125971d45/CLT2-13-e12300-g002.jpg

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The international WAO/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update.
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