Worm Margitta, Günther Claudia, Claussen Martin, Keyßer Gernot, Kötter Ina, Riemekasten Gabriela, Siegert Elise, Blank Norbert, Sunderkötter Cord, Zeidler Gabriele, Korsten Peter
Abteilung für Allergologie und Immunologie, Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Deutschland.
Z Rheumatol. 2024 Dec;83(10):844-851. doi: 10.1007/s00393-024-01542-7. Epub 2024 Jul 25.
Interdisciplinary medical treatment is required to care for patients with complex autoimmune diseases. Although there are an increasing number of interdisciplinary centers for autoimmune diseases in Germany, they are not yet available throughout the country and the focuses and interdisciplinary structures are not organized according to a generally agreed standard. Furthermore, they are not regularly reflected in the general care structure.
To analyze the care structure using as an example an established center and a clinical case to demonstrate the usefulness of in-house standardized procedures.
In order to determine the status quo regarding interdisciplinary centers for autoimmune diseases in Germany, a university hospital is exemplarily presented for a structural analysis and a case presentation from another center to demonstrate the importance of an interdisciplinary patient care.
At the selected center for autoimmune diseases of the university hospital, patients with autoimmune diseases receive interdisciplinary care from experts from various disciplines. The structures are anchored in an organizational chart. The case report demonstrates a standardized diagnostic and therapeutic pathway (standardized operating procedures, SOP) in a patient with systemic sclerosis and lung involvement.
The article discusses which measures are necessary across disciplines for comprehensive diagnostics and treatment of certain autoimmune diseases, which challenges arise during implementation and which advantages can arise compared to guidelines because, among other things, they can be immediately adapted. The establishment of a national consensus for the structure, necessary settings and implementation into patient care within an interdisciplinary center for autoimmune diseases is desirable.
对于患有复杂自身免疫性疾病的患者,需要进行跨学科医疗护理。尽管德国的自身免疫性疾病跨学科中心数量不断增加,但在全国范围内尚未普及,且其重点和跨学科结构并未按照普遍认可的标准进行组织。此外,它们在一般护理结构中也未得到定期体现。
以一个成熟的中心和一个临床病例为例,分析护理结构,以证明内部标准化程序的实用性。
为了确定德国自身免疫性疾病跨学科中心的现状,以一家大学医院为例进行结构分析,并展示另一个中心的病例,以说明跨学科患者护理的重要性。
在选定的大学医院自身免疫性疾病中心,自身免疫性疾病患者接受来自各个学科专家的跨学科护理。这些结构在组织结构图中有明确规定。病例报告展示了一名系统性硬化症合并肺部受累患者的标准化诊断和治疗路径(标准化操作程序,SOP)。
本文讨论了对于某些自身免疫性疾病进行全面诊断和治疗,跨学科需要采取哪些必要措施,实施过程中会出现哪些挑战,以及与指南相比可能产生哪些优势,因为指南等在某些方面无法立即调整。在自身免疫性疾病跨学科中心内,就结构、必要设置以及在患者护理中的实施达成全国共识是很有必要的。