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β地中海贫血:展望未来,应对未满足的需求和挑战。

Beta thalassemia: Looking to the future, addressing unmet needs and challenges.

作者信息

Angastiniotis Michael

机构信息

Thalassaemia International Federation, Nicosia, Cyprus.

出版信息

Ann N Y Acad Sci. 2024 Feb;1532(1):63-72. doi: 10.1111/nyas.15097. Epub 2024 Jan 13.

Abstract

Thalassemia management has reached new milestones, with new therapies promising the dawning of a new era. However, conventional and new approaches require accessibility, affordability, acceptability/adherence by patients, and medical expertise from healthcare providers. Current treatments still do not offer the expected duration and quality of life, and inequalities in patient care are almost a universal phenomenon. To understand the requirements to achieve improved care, including the adoption of new therapies, for the maximum number of the global patient population, it is necessary to recognize the weaknesses that are experienced in the present so that future corrective action can be taken. Deficits in service provision are due to poor political and financial support, lack of prioritization during resource rationing, and absence of epidemiological information for policy making. These system weaknesses require improved resource management and would benefit from patient support organizations, improved psychosocial support and patient welfare, and an increase in professional expertise through educational programs. Medical products and technology must also be made affordable and widely available, and the curative treatments and cheaper approaches to technology must be recognized as resource saving. Improvements in the access to innovative and quality care, and even a cure, require concerted actions by all stakeholders, including physicians and the patient community.

摘要

地中海贫血的管理已达到新的里程碑,新疗法预示着一个新时代的到来。然而,传统方法和新方法都需要具备可及性、可负担性、患者的可接受性/依从性,以及医疗服务提供者的专业知识。目前的治疗方法仍无法提供预期的治疗时长和生活质量,患者护理方面的不平等几乎是普遍现象。为了了解如何满足更多全球患者群体改善护理的需求,包括采用新疗法,有必要认识到当前存在的不足,以便未来能够采取纠正措施。服务提供方面的缺陷是由于政治和财政支持不足、资源分配过程中缺乏优先排序,以及缺乏用于政策制定的流行病学信息。这些系统缺陷需要改善资源管理,而患者支持组织、改善心理社会支持和患者福利,以及通过教育项目增加专业知识将有助于改善这一状况。医疗产品和技术也必须做到价格可承受且广泛可得,并且必须认识到治愈性治疗和更廉价的技术方法具有节省资源的作用。改善获得创新和优质护理乃至治愈的机会,需要包括医生和患者群体在内的所有利益相关者共同采取行动。

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