耳鼻喉过敏患者旅程映射:过敏免疫疗法坚持的框架
David E Melon1, Harold C Pillsbury2, Willard C Harrill1
1Carolina Ear, Nose & Throat-Sinus and Allergy Center, PA, Hickory, North Carolina, U.S.A.
The Laryngoscope
|August 14, 2024
概括
预测过早停止过敏原特异性免疫疗法 (AIT) 仍然具有挑战性. 实时患者报告的数据虽然具有信息性,但在本研究中没有预测早期停止AIT治疗.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过敏原特异性免疫疗法 (AIT) 对过敏性疾病有效,但患有过早停止的高率.
- 了解早期AIT停止的驱动因素对于改善治疗坚持和结果至关重要.
- 目前缺乏AIT终止的预测模型.
研究的目的:
- 调查新型患者旅程图和实时电子健康状况仪器 (eHSI) 是否可以预测AIT的过早终止.
- 为了确定与早期停止AIT相关的患者感知因素 (成本,承诺,益处).
主要方法:
- 在单个耳鼻喉科AIT计划中,在5年内进行了一项横截面观察性研究.
- 开发了一个耳鼻喉过敏患者旅程地图,以指导通过eHSI收集实时,患者报告的数据.
- 使用相关性分析和逻辑回归来评估eHSI反应的预测价值.
主要成果:
- 总共收集了61,406个数据点,eHSI完成率为81.3%.
- 尽管收集了大量的数据,但实时的eHSI反应并没有预测个体患者过早停止AIT.
- 很大一部分患者 (64.4%) 在第一年内停止了AIT,其中皮下和舌下AIT的不完成率很高.
结论:
- 患者旅程映射可以为护理模式和参与策略提供信息,但通过eHSI感知到的AIT成本,效益和便利性与过早戒烟没有相关性.
- 当前的临床直觉可能无法捕捉驱动早期AIT停药的动态因素.
- 需要使用大型以患者为中心的数据集的未来预测工具,以实现个性化的AIT方法,以减少早产和医疗保健成本.
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