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英国国民医疗服务体系中卫生政策在预防静脉血栓栓塞方面的作用——回顾过去,展望未来。

The role of health policy in the prevention of venous thromboembolism in the UK National Health Service-Learning from the past, looking to the future.

作者信息

Beresford Matthew James, Hunt Beverley J, Roberts Lara, Horner Daniel, Arya Roopen, Fowler Aidan

机构信息

North Bristol NHS Trust, Southmead Road Westbury on Trym BS10 5NB, UK.

NHS England and NHS Improvement London, London, UK.

出版信息

Future Healthc J. 2024 Feb 28;11(1):100016. doi: 10.1016/j.fhj.2024.100016. eCollection 2024 Mar.

Abstract

Venous thromboembolism is the third most common cause of cardiovascular death globally and many diagnoses are preventable. The UK NHS has led international efforts to reduce VTE, particularly hospital-associated VTE, through coordinated national policy action and world-leading research. Despite this, VTE remains an important cause of morbidity and mortality in the UK, as underlined by the recent COVID-19 pandemic. Future reductions in VTE incidence/deaths will require progress on several fronts: a better understanding of case mix; revisiting VTE risk assessment, focussing on thromboprophylaxis failure and improving awareness of VTE amongst clinicians and the public. Changes to healthcare delivery, with care increasingly delivered outside of hospital, alongside changing disease patterns, including the rise in obesity, have huge implications for VTE and will dramatically alter prevention. The UK, with its nationalised healthcare model and long history of policy action on VTE, provides a unique lens through which to study past successes and future priorities for VTE prevention.

摘要

静脉血栓栓塞是全球心血管疾病死亡的第三大常见原因,许多诊断是可以预防的。英国国民医疗服务体系(NHS)通过协调一致的国家政策行动和世界领先的研究,引领了国际上减少静脉血栓栓塞(VTE)的努力,特别是与医院相关的VTE。尽管如此,正如最近的新冠疫情所凸显的那样,VTE在英国仍然是发病和死亡的一个重要原因。未来要降低VTE的发病率/死亡率,需要在几个方面取得进展:更好地了解病例组合;重新审视VTE风险评估,重点关注血栓预防失败的情况,并提高临床医生和公众对VTE的认识。随着医疗服务越来越多地在院外提供,以及疾病模式的变化,包括肥胖症的增加,医疗服务的变化对VTE有巨大影响,并将极大地改变预防措施。英国拥有国有化的医疗模式以及在VTE方面长期的政策行动历史,为研究VTE预防的过去成功经验和未来优先事项提供了一个独特的视角。

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本文引用的文献

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Annotation: Developing a national programme for VTE prevention.注释:制定全国静脉血栓栓塞症预防计划。
Br J Haematol. 2017 Jul;178(1):162-170. doi: 10.1111/bjh.14769. Epub 2017 May 23.
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Global public awareness of venous thromboembolism.全球公众对静脉血栓栓塞症的认知。
J Thromb Haemost. 2015 Aug;13(8):1365-71. doi: 10.1111/jth.13031. Epub 2015 Jul 14.

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