University of Massachusetts Chan Medical School, Worcester, MA, USA.
Department of Statistics, University of Michigan, Ann Arbor, MI, USA.
J Clin Immunol. 2024 Jan 17;44(2):51. doi: 10.1007/s10875-024-01652-6.
Ataxia-telangiectasia (A-T) is a rare genetic condition with malfunctioning DNA repair processes resulting in significant clinical findings, including progressive neurologic decline, elevated malignancy risk, immunodeficiency, oculocutaneous telangiectasias, and severe pulmonary disease. Research has been limited into the quality of life of such patients and yet to be completed are studies quantitatively analyzing psychosocial, physical, and cognitive patient-reported outcomes (PROs) within the A-T population.
PRO evaluations of 90 international adult and pediatric A-T patients and their caregivers were completed via secure online administration of Patient-Reported Outcomes Measurement Information System (PROMIS) short forms evaluating anger, cognition, mood, social health, fatigue, pain, anxiety, and upper extremity function. The impact of age, gender, race/ethnicity, prior malignancy diagnosis, and current supportive treatment interventions on such PROs was additionally assessed. Finally, given the importance of medical providers in the care of A-T patients and the impact of patient satisfaction on healthcare outcomes, we further analyzed, via a novel survey, how patients and caregivers perceived their primary A-T healthcare provider's A-T expertise, trustworthiness, accessibility, and level of compassion.
RESULTS/CONCLUSION: It was found that a diagnosis of A-T complexly impacts patient PROs, but such data offers the potential for preventative and therapeutic interventions to improve the care of such patients. While most A-T patients and their caregivers feel their primary A-T medical provider has expertise and compassion in addition to being accessible and trustworthy, a significant percentage of study subjects did not agree that their provider was an expert in A-T or overall trustworthy.
共济失调毛细血管扩张症(A-T)是一种罕见的遗传疾病,其 DNA 修复过程出现故障,导致出现显著的临床发现,包括进行性神经功能衰退、恶性肿瘤风险增加、免疫缺陷、眼皮肤毛细血管扩张症和严重的肺部疾病。针对此类患者的生活质量的研究十分有限,目前尚未完成定量分析 A-T 人群中社会心理、身体和认知患者报告结局(PROs)的研究。
通过安全的在线管理,对 90 名国际成人和儿科 A-T 患者及其护理人员进行了 PRO 评估,使用患者报告结局测量信息系统(PROMIS)短表评估愤怒、认知、情绪、社交健康、疲劳、疼痛、焦虑和上肢功能。此外,还评估了年龄、性别、种族/民族、既往恶性肿瘤诊断和当前支持性治疗干预对这些 PRO 的影响。鉴于医疗服务提供者在 A-T 患者护理中的重要性以及患者满意度对医疗保健结果的影响,我们还通过一项新的调查进一步分析了患者和护理人员如何看待其主要 A-T 医疗保健提供者的 A-T 专业知识、值得信赖、可及性和同情心。
结果/结论:研究发现,A-T 诊断复杂地影响了患者的 PRO,但此类数据为预防和治疗干预提供了潜力,以改善此类患者的护理。尽管大多数 A-T 患者及其护理人员认为他们的主要 A-T 医疗提供者在可及性、值得信赖、有同情心的基础上还具有专业知识,但仍有相当一部分研究对象认为他们的提供者不是 A-T 方面的专家或整体值得信赖。