《帕金森病深部脑刺激治疗机会不均等及干预措施研究:文献综述》

Disparities in Access to Deep Brain Stimulation for Parkinson's Disease and Proposed Interventions: A Literature Review.

机构信息

Vanderbilt University School of Medicine, Nashville, Tennessee, USA,

Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

出版信息

Stereotact Funct Neurosurg. 2024;102(3):179-194. doi: 10.1159/000538748. Epub 2024 May 2.

Abstract

BACKGROUND

Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD), but disparities exist in access to DBS along gender, racial, and socioeconomic lines.

SUMMARY

Women are underrepresented in clinical trials and less likely to undergo DBS compared to their male counterparts. Racial and ethnic minorities are also less likely to undergo DBS procedures, even when controlling for disease severity and other demographic factors. These disparities can have significant impacts on patients' access to care, quality of life, and ability to manage their debilitating movement disorders.

KEY MESSAGES

Addressing these disparities requires increasing patient awareness and education, minimizing barriers to equitable access, and implementing diversity and inclusion initiatives within the healthcare system. In this systematic review, we first review literature discussing gender, racial, and socioeconomic disparities in DBS access and then propose several patient, provider, community, and national-level interventions to improve DBS access for all populations.

摘要

背景

深部脑刺激(DBS)是治疗帕金森病(PD)的有效方法,但在性别、种族和社会经济方面,获得 DBS 的机会存在差异。

摘要

与男性相比,女性在临床试验中的代表性不足,接受 DBS 的可能性也较小。少数族裔也不太可能接受 DBS 手术,即使在控制疾病严重程度和其他人口统计学因素后也是如此。这些差异可能对患者的护理、生活质量和管理致残性运动障碍的能力产生重大影响。

关键信息

解决这些差异需要提高患者的意识和教育,尽量减少公平获得的障碍,并在医疗保健系统中实施多样性和包容性举措。在本系统评价中,我们首先回顾了讨论 DBS 机会获取方面的性别、种族和社会经济差异的文献,然后提出了几项针对患者、提供者、社区和国家层面的干预措施,以改善所有人群的 DBS 机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e35/11152032/a1b18fd3bb33/sfn-2024-0102-0003-538748_F01.jpg

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