Adherence to guidelines for the treatment of Behçet's syndrome in New York and Amsterdam.
Clin Exp Rheumatol
; 35 Suppl 108(6): 55-59, 2017.
Article
en En
| MEDLINE
| ID: mdl-28406760
ABSTRACT
OBJECTIVES:
To assess adherence to published guidelines for the treatment of Behçet's syndrome (BS) in two geographic areas.METHODS:
We extracted guideline statements from the 2008 EULAR recommendations. Adherence to these statements was evaluated retrospectively in both New York (USA) and Amsterdam (The Netherlands), by reviewing records from patients fulfilling the ISG criteria. We analysed data per statement and event, and divided data according to the year in which an event occurred. We compared events prior to 2009 to those after publication of the EULAR recommendations (2009 and later).RESULTS:
474 patients were evaluated, 24 of whom were from Amsterdam. Treatment adherence varied substantially across various Behçet's manifestations, ranging from 21% vs. 31% in posterior uveitis, 50% vs. 25% in arterial disease, 29% vs. 29% in arthritis and 38% vs. 55% in erythema nodosum to 65% vs. 67% in deep venous thrombosis (DVT), before and after publication of the guidelines respectively. Topical treatment of mucocutaneous disease was only 2% vs. 8%, whereas adherence in neuro-Behçet was ≥ 94% and 100% in gastrointestinal disease.CONCLUSIONS:
Adherence to treatment guidelines varies substantially by Behçet's manifestation. Lack of adherence in manifestations such as eye disease and arthritis suggests that current recommendations are not sufficient or other concurrent manifestations require more aggressive treatment. The extensive use of anti-TNF agents might indicate a shift towards more aggressive treatment. Thus, our results suggest the 2008 guidelines were not in line with treatment in clinical practice over the past years and the recent revision of the recommendations was indeed needed.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_acesso_equitativo_servicos
Asunto principal:
Pautas de la Práctica en Medicina
/
Síndrome de Behçet
/
Guías de Práctica Clínica como Asunto
/
Adhesión a Directriz
/
Disparidades en Atención de Salud
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
/
Europa
Idioma:
En
Revista:
Clin Exp Rheumatol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos