Management of chronic spontaneous urticaria: a worldwide perspective.
Management of chronic spontaneous urticaria: a worldwide perspective.
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DOI：
10.1186/s40413-018-0193-4
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
WAO Junior Members Group
中科院分区：
文献类型：
--
作者：
Kolkhir P;Pogorelov D;Darlenski R;Caminati M;Tanno LK;Le Pham D;Gonzalez-Estrada A;Antolín-Amérigo D;Dimov V;Weller K;Sánchez-Borges M;Ansotegui I;Maurer M;WAO Junior Members Group
慢性自发性荨麻疹(CSU)的诊断和治疗方法在世界各地有所不同。我们试图确定世界各地的医生遵守国际和国家的荨麻疹指南，以及偏离指南的动机。2017年3月，世界过敏症组织(WAO)创建了一份基于网络的问卷，并通过电子邮件向世界过敏症组织所有成员学会的代表、美国过敏、哮喘和免疫学会(AAAAI)的成员以及世界过敏症组织青年成员小组(JMG)的成员发出了调查问卷，无论其专业、从属或国籍如何。我们收到了来自99个国家的参与医生的1140份完整的调查问卷。几乎所有的参与者(96%)都知道至少有一种风疹指南，并报告说他们遵循了指南。然而，五分之一遵循指南的医生(22%)报告偏离了指南。依赖自己的临床经验是偏离指南或不遵循指南的最常见原因(44%)。年轻(<； 40岁)和经验较少的医生更多地遵循指导方针，而不是年长和有经验的医生经常偏离指导方针。与不遵循指南的医生相比，遵循指南的医生显示出更高的常规订购完整血细胞计数、血沉、C反应蛋白、抗甲状腺抗体和促甲状腺激素以及进行自体血清皮肤试验的比率。与不遵循指南的医生相比，遵循指南的医生显示使用第二代抗组胺药物作为一线治疗慢性萎缩性胃炎的比率更高(p = 0.001)，并且更经常观察到这些药物的更高疗效(或者更有信心它会起作用，p <； 0.019)。医生的特点(如年龄、临床经验和专业)以及国别和地区特点(如CSU治疗药物的可获得性)对遵守风疹指南和CSU患者护理有重要影响，应在未来的研究中更详细地加以阐述。本文的在线版本(10.1186/s40413-0180193-4)包含补充材料，可供授权用户使用。
The approaches to the diagnosis and treatment of chronic spontaneous urticaria (CSU) differ in various parts of the world. We sought to determine the adherence to international and national urticaria guidelines as well as the motives to deviate from the guidelines among physicians worldwide. A web-based questionnaire was created and launched via e-mail by the World Allergy Organization (WAO) to representatives of all WAO Member Societies, the members of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the members of the WAO Junior Members Group (JMG), regardless of the specialty, affiliation, or nationality in March 2017. We received 1140 completed surveys from participating physicians from 99 countries. Virtually all participants (96%) were aware of at least one urticaria guideline and reported that they follow a guideline. However, one in five physicians who follow a guideline (22%) reported to deviate from it. Reliance on own clinical experience is the most frequent reason for deviation from guidelines or not following them (44%). Young (< 40 years) and less experienced physicians more often follow a guideline and less often deviate than older and experienced ones. Physicians who follow a urticaria guideline showed higher rates of routinely ordering a complete blood count, the erythrocyte sedimentation rate, C-reactive protein, anti-thyroid antibodies, and thyroid-stimulating hormone and of performing the autologous serum skin test as compared to those who do not. Physicians who follow a urticaria guideline showed higher rates of using second generation antihistamines as their first-line treatment of CSU (p = 0.001) and more frequently observed higher efficacy of these drugs (or had more confidence that it would work, p < 0.019) as compared to those who do not follow the guidelines. Physicians’ characteristics (e.g. age, clinical experience, and specialty) and country specifics and regional features (e.g. availability of drugs for CSU treatment) importantly influence adherence to urticaria guidelines and CSU patient care and should be addressed in more detail in future research. The online version of this article (10.1186/s40413-018-0193-4) contains supplementary material, which is available to authorized users.
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14.2
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