在2008年至2021年期间,英格兰四种主要慢性呼吸道疾病的患者途径
Anne E Ioannides1,2, Ann D Morgan3,2, Jennifer K Quint3,2
1Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK a.ioannides@imperial.ac.uk.
BMJ open respiratory research
|August 29, 2024
概括
在英格兰诊断慢性呼吸道疾病,如喘和COPD,揭示了显著的延迟和错过的机会. 患者路径显示,从症状发作到诊断的等待时间很长,这凸显了改善诊断策略的必要性.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 慢性呼吸道疾病缺乏明确的诊断时间表.
- 了解诊断途径对于及时干预至关重要.
- 这项研究重点关注英格兰四个主要的呼吸系统疾病.
研究的目的:
- 探索喘,COPD,ILD和支气管炎的诊断途径和时间.
- 分析患者从症状呈现到诊断和治疗的过程.
- 确定慢性呼吸道疾病诊断的潜在延迟和改善领域.
主要方法:
- 使用非识别电子健康记录 (CPRD Aurum与HES相关).
- 在三个时间段中获得了喘,COPD,ILD和支气管切除的队列.
- 分析了诊断前和诊断后2年的患者数据,跟踪症状,测试和医疗保健咨询.
主要成果:
- 大多数诊断 (超过87%) 来自初级保健.
- 症状报告有所不同,在支气管切除症中更高 (67.9%-71.8%).
- 对于喘 (14%-32.7%) 和ILD (2.6%-3.3%) 的诊断测试使用率较低,在2020/2021年进一步下降.
- 从症状到诊断的中位时间从约7.5个月 (喘) 到约13.5个月 (支气管切除症).
- 在研究期间,喘和COPD的诊断时间增加了.
- 诊断后的治疗开始有所不同,喘/COPD的治疗几乎是瞬间的,ILD/支气管病的治疗时间较长.
结论:
- 目前的诊断途径为早期疾病检测和管理提供了错失的机会.
- 需要改进疾病编码和诊断过程.
- 优化患者途径可以导致慢性呼吸道疾病的更好的结果.
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