在初级保健中确定风险患类风湿性关节炎的人:定性研究
Anna M Anderson1, Suzanne Richards2, Caroline Flurey3
1University of Leeds Faculty of Medicine and Health, Leeds Institute of Health Sciences, Leeds, United Kingdom.
概括
在初级保健中早期检测类风湿性关节炎 (RA) 通过使用反周期性素化 (anti-CCP) 测试的预测模型来改进. 这种方法有助于识别 RA 发展风险较高的个体.
科学领域:
- 类风湿病学 类风湿病学
- 主要护理医学 医疗保健
- 临床决策支持 临床决策支持
背景情况:
- 在初级保健中,类风湿性关节炎 (RA) 的诊断往往会延迟.
- 早期识别对于及时干预和改善患者结果至关重要.
- 抗循环氨基 (anti-CCP) 抗体测试可以识别患有RA风险较高的个体.
研究的目的:
- 了解当前的初级保健实践,以识别和转诊疑似RA病例.
- 为了探索临床医生的行为,需要实施针对性抗CCP测试的预测模型.
- 评估使用预测模型用于早期RA风险分层在初级保健中的可行性.
主要方法:
- 在英格兰的初级保健机构进行的定性描述性研究.
- 与全科医生 (GP) 和肌肉骨第一接触医生的半结构面试.
- 采访数据的框架分析,以确定与RA识别和预测模型实施相关的主题.
主要成果:
- 目前的RA识别和转介途径存在显著差异,包括反CCP测试实践.
- 成功实施需要临床医生相信该模型的好处,跨专业的合作,并整合到临床工作流程.
- 临床医生对抗CCP预测模型的看法总体上是积极的,表明可能被采用.
结论:
- 在初级保健中指导针对性抗CCP测试的预测模型似乎可用于早期RA风险识别.
- 需要进一步的研究来评估与此拟议的RA管理途径相关的好处,风险和成本.
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