在比利时,为心力衰竭患者实施指导方针导向的医疗疗治疗:Delphi小组方法
Joke Devoldere1, Steven Droogmans2, Ward A Heggermont3
1Medical Affairs, BioPharmaceuticals, AstraZeneca, Groot-Bijgaarden, Belgium.
Acta cardiologica
|September 10, 2024
概括
比利时专家达成共识,对心力衰竭与减少喷射率 (HFrEF) 实施指导方针导向医学治疗 (GDMT). 关键建议包括快速启动四种基石疗法和个性化治疗顺序,以获得最佳的患者结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床实践指南 临床实践指南
背景情况:
- 2021年欧洲心脏病学会 (ESC) 的指导方针主张为心力衰竭与减少喷射率 (HFrEF) 制定一个由四大支柱组成的医学治疗策略,强调几乎同时启动.
- 目前,临床实践中缺乏该策略的实际实施指南.
- 一个由12名比利时心力衰竭专家组成的德尔菲小组召开会议,以达成共识,将指南导向医学治疗 (GDMT) 纳入比利时对HFrEF患者的临床实践中,同时考虑地方因素,如报销.
研究的目的:
- 为了在比利时实现GDMT对HFrEF的实际实施,达成专家共识.
- 解决启动四大支柱治疗策略的实际指导的缺口.
- 在达成共识的过程中考虑当地特点,包括退款标准.
主要方法:
- 一个三轮的德尔菲过程,涉及12位具有地理代表性的比利时心脏病专家.
- 最初的开放式问题在进行定性分析后演变为39个陈述.
- 声明被分类为新诊断的和慢性HFrEF患者.
主要成果:
- 达成共识,在HFrEF诊断后7-14天内启动四种基石医学疗法,优先考虑启动而不是升级定位.
- 由于患者的变化和国家退款标准,在开始治疗的固定顺序上没有达成共识.
- 专家们强调了根据个体患者表现和并发症量身定制治疗调整,以及定期随访以优化治疗的重要性.
结论:
- 这个国家德尔菲共识为比利时心脏病学家提供了关于在HFrEF中实施GDMT的实际指导.
- 共识强调需要在新诊断的HFrEF患者中快速启动四种基石疗法.
- 个性化治疗顺序和定期随访对于优化HFrEF管理中的医疗治疗至关重要.
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