在多发性硬化症中,临床层面的护理质量与患者层面的结果之间的关联
Anna H He1, Ali Manouchehrinia1, Anna Glaser2
1Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden/Centre for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
概括
多发性硬化症 (MS) 的优质护理改善了复发性患者的治疗结果. 较快的治疗和频繁的访问与更好的残疾和症状得分有关,但对于渐进性发病的MS而言并非如此.
科学领域:
- 神经学 神经学
- 医疗保健的质量 医疗保健的质量
- 临床结果研究研究
背景情况:
- 目前多发性硬化症 (MS) 护理质量指南是基于共识的,有效性不明.
- 临床层面的护理质量对MS患者结果的影响仍然不清楚.
研究的目的:
- 调查临床层面的护理质量是否影响多发性硬化症 (MS) 的临床和患者报告结果.
主要方法:
- 一项全国性的观察队列研究利用了瑞典多发性硬化症注册 (2005-2015) 对成人发病的多发性硬化症患者.
- 质量指标包括访问密度,MRI密度,疾病修饰疗法 (DMT) 启动时间和数据完整性.
- 评估的结果是扩展残疾状态量表 (EDSS) 和MS影响量表 (MSIS-29) 评分,根据患者特征和DMT暴露进行调整.
主要成果:
- 在复发性MS中,所有质量指标都对EDSS和身体症状产生了积极影响.
- 较快的治疗开始和更频繁的访问与改善的心理症状和较低的EDSS分数有关.
- 临床层面的护理质量没有显示出对逐渐发病的多发性硬化症的结果有重大影响.
结论:
- 特定的护理质量指标与复发性MS的改善结果相关,但与逐渐发作的MS无关.
- 未来的多发性硬化症 (MS) 指导方针应纳入针对疾病过程的具体建议,以提高护理质量.
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