多发性硬化症临床后续检查的障碍:一项全国性的基于登记册的研究
Agata Beczek1,2, Eskild Morten Landt3, Lars Kristian Storr1
1Department of Neurology, Zealand University Hospital, Roskilde, Denmark.
Multiple sclerosis journal - experimental, translational and clinical
|December 20, 2024
概括
在丹麦,许多患有多发性硬化症 (MS) 的人错过了诊所访问,特别是那些没有接受疾病修饰治疗或在农村地区的人. 这表明在MS护理的获取和管理方面存在重大不平等.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 丹麦的专业多发性硬化症 (MS) 诊所提供免费治疗,但患者之间一致的临床随访并不普遍.
- 了解缺勤模式对于在多发性硬化症 (MS) 管理中提供公平的医疗保健至关重要.
研究的目的:
- 为了识别患有多发性硬化症 (MS) 的个人,这些人不定期参加丹麦MS诊所.
- 在多发性硬化症 (MS) 患者群体中确定与临床随访出席率低相关的关键障碍和因素.
主要方法:
- 利用来自丹麦多发性硬化病登记处的数据与其他国家登记处 (2000-2020年) 联系在一起.
- 采用时间依赖的考克斯回归分析来确定影响临床随访人数低的因素.
- 危险比率 (HRs) 被计算出来,以对相关因素的重要性进行排名.
主要成果:
- 在10,175名患有多发性硬化症的成年人中,38.0%的人每年少于一次诊断.
- 与访问频率减少相关的关键因素包括从未接受疾病修饰治疗 (HR:0.48),在2009年之前诊断 (HR:0.79),位于外围地区 (HR:0.82),进展性MS类型 (HR:0.88),以及在诊断时缺乏症状治疗 (HR:0.91).
- 这些发现揭示了与治疗史,疾病进展和地理位置相关的差异.
结论:
- 该研究强调了丹麦多发性硬化症 (MS) 患者护理的重大疾病特异性和地理差异.
- 迫切需要实施战略来解决这些差异,重点关注渐进性多发性硬化症表型和需要全面支持性护理的表型.
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