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罕见病临床管理中的挑战以及基于中心的多学科解决方案创建方法。

Challenges in the clinical management of rare diseases and center-based multidisciplinary approach to creating solutions.

作者信息

Gunes D, Karaca M, Durmus A, Ak B, Aktay Ayaz N, Altınel Z U, Aslanger A D, Atalar F, Balci M C, Bilgin L, Darendeliler F, Demirkol D, Durmaz O, Gedikbasi A, Inan Balci E, Ince E Z, Karadag S G, Keskindemirci G, Nisli K, Ozcetin M, Somer A, Unuvar A, Uysalol M, Yildiz E, Yuruk Yildirim Z N, Demirkol M, Gokcay G F

机构信息

Department of Rare Diseases, Institute of Child Health, Istanbul University, Istanbul, Turkey.

Division of Nutrition and Metabolism, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

出版信息

Eur J Pediatr. 2025 Apr 5;184(5):281. doi: 10.1007/s00431-025-06101-z.

Abstract

UNLABELLED

The diagnosis and treatment of rare diseases present significant global challenges. This study aimed to identify the difficulties faced by specialists in the diagnosis and management of rare diseases, as well as to gather their recommendations for potential solutions. An expert committee specializing in inborn metabolic disease and genetics developed a comprehensive survey, which was then distributed online to professionals working with rare diseases. A total of 21 specialists actively engaged in the management of rare diseases participated in the survey. All participants acknowledged the substanstial significant diagnostic challenges associated with rare diseases, with 86% indicating that these diagnostic challenges negatively affect their clinical practice. The primary obstacles encountered in the diagnosis and follow-up of rare diseases were low awareness, a lack of a multidisciplinary approach, insufficient numbers of specialists and inadequate infrastructure, limited newborn screening programs, challenges in accessing treatment, and insufficient psychosocial support. All participants emphasized the need for a multidisciplinary approach in the management of rare diseases. Proposed solutions included enhanced training for healthcare professionals, the establishment of multidisciplinary teams and diagnostic algorithms, the regular convening of councils and meetings, and the establishment of robust registries. While all participants rated their own clinical experience as proficient in diagnosing and treating rare diseases, the establishment of multidisciplinary teams was the most frequently suggested area for improvement.

CONCLUSION

Addressing the challenges in the diagnosis, treatment, and monitoring of rare diseases requires a multifaceted approach, including raising awareness, enhancing patient services, developing robust research and improving the infrastructure, establishing multidisciplinary care frameworks, and implementing preventive medicine and social policies.

WHAT IS KNOWN

• It is estimated that over 300 million people globally are living with one or more rare diseases. The process of diagnosis, treatment, and follow-up of rare diseases involves significant global challenges.

WHAT IS NEW

• In our study, the difficulties encountered by specialists in the diagnosis and treatment of rare diseases in Türkiye and solution suggestions are presented. This is the first study on this subject in Türkiye.

摘要

未标注

罕见病的诊断和治疗给全球带来了重大挑战。本研究旨在确定专家在罕见病诊断和管理中面临的困难,并收集他们对潜在解决方案的建议。一个专门从事先天性代谢疾病和遗传学的专家委员会制定了一项全面的调查问卷,然后在线分发给从事罕见病工作的专业人员。共有21名积极参与罕见病管理的专家参与了调查。所有参与者都承认与罕见病相关的巨大诊断挑战,86%的人表示这些诊断挑战对他们的临床实践产生了负面影响。罕见病诊断和随访中遇到的主要障碍包括认识不足、缺乏多学科方法、专家数量不足和基础设施不完善、新生儿筛查项目有限、获得治疗的挑战以及社会心理支持不足。所有参与者都强调在罕见病管理中需要多学科方法。提出的解决方案包括加强对医疗保健专业人员的培训、建立多学科团队和诊断算法、定期召开委员会和会议以及建立完善的登记系统。虽然所有参与者都将自己的临床经验评为精通罕见病的诊断和治疗,但建立多学科团队是最常被建议改进的领域。

结论

应对罕见病诊断、治疗和监测中的挑战需要采取多方面的方法,包括提高认识、加强患者服务、开展有力的研究和改善基础设施、建立多学科护理框架以及实施预防医学和社会政策。

已知信息

• 据估计,全球有超过3亿人患有一种或多种罕见病。罕见病的诊断、治疗和随访过程涉及重大的全球挑战。

新信息

• 在我们的研究中,介绍了土耳其专家在罕见病诊断和治疗中遇到的困难及解决方案建议。这是土耳其关于该主题的第一项研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a1/11972228/b92e03fe428b/431_2025_6101_Fig1_HTML.jpg

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