Modelling of patient journey in chronic spontaneous urticaria: Increasing awareness and education by shorten patients' disease journey in Germany.

Autor: Maurer M; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany., Augustin M; Universitätsklinikum Hamburg Eppendorf, IVDP, Hamburg, Germany., Bauer S; Urtikaria-Helden, gUG, Koblenz, Germany., Ekanayake-Bohlig S; MENSINGDERMA Research, Hamburg, Germany., Kircher P; St. Ulrich-Apotheke, Peißenberg, Germany., Knöll A; Hautarztpraxis, Falkensee, Germany., Kramps T; Novartis Pharma GmbH, Nuremberg, Germany., Kurzen H; Haut- und Laerzentrum Freising, Freising, Germany., Laemmel S; Deutscher Allergie- und Asthmabund e.V. - DAAB, Berlin, Germany., Novak N; Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany., Oppel E; Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany., Pirouzmandi L; Praxis Nettlingen, Sölde, Germany., Rebhan M; Novartis Institute for Biomedical Research, DAX Translational Research & Data Science, Basel, Switzerland., Reimnitz U; Praxis Schwerin, Schwerin, Germany., Richter-Huhn G; Hautarztpraxis Dresden, Dresden, Germany., Schwarz B; Hautarztpraxis Langenau, Langenau, Germany., Schwichtenberg U; Derma-Nord Hautarztpraxis Bremen, Bremen, Germany., Staubach P; Department of Dermatology, University Medical Center Mainz, Mainz, Germany., Termeer C; Praxis, Stuttgart, Germany.; Department of Dermatology, University of Freiburg, Freiburg, Germany., Thielen A; Novartis Pharma GmbH, Nuremberg, Germany., Varga K; Praxis Seifhennersdorf, Seifhennersdorf, Germany., von Bubnoff D; Department Dermatology, Allergology and Venereology, University Medical Center Lübeck, Lübeck, Germany., Zink A; Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München, Munich, Germany.; Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden., Gmeiner B; Novartis Pharma GmbH, Nuremberg, Germany., Nathan P; Novartis Pharma GmbH, Nuremberg, Germany.
Jazyk: angličtina
Zdroj: Journal of the European Academy of Dermatology and Venereology : JEADV [J Eur Acad Dermatol Venereol] 2024 Nov; Vol. 38 (11), pp. 2093-2101. Date of Electronic Publication: 2024 Mar 05.
DOI: 10.1111/jdv.19940
Abstrakt: Background: Chronic spontaneous urticaria (CSU) is both physically and emotionally stressful, and guideline recommendations are often not optimally implemented in clinical practice. The objective of this study was to provide an overview on the patient journey in CSU and to develop a mathematical model based on solid data.
Methods: The journey of CSU patients in Germany was traced through literature review and expert meetings that included medical experts, pharmacists and representatives of patient organizations. The current situation's main challenges in the patient journey (education, collaboration and disease management) were discussed in depth. Then, a probabilistic model was developed in a co-creation approach to simulate the impact of three potential improvement strategies: (1) patient education campaign, (2) medical professional education programme and (3) implementation of a disease management programme (DMP).
Results: Chronic spontaneous urticaria patients are severely burdened by delays in diagnosis and optimal medical care. Our simulation indicates that in Germany, it takes on average of 3.8 years for patients to achieve disease control in Germany. Modelling all three optimization strategies resulted in a reduction to 2.5 years until CSU symptom control. On a population level, the proportion of CSU patients with disease control increased from 44.2% to 58.1%.
Conclusions: In principle, effective CSU medications and a disease-specific guideline are available. However, implementation of recommendations is lagging in practice. The approach of quantitative modelling of the patient journey validates obstacles and shows a clear effect of multiple interventions on the patient journey. The data generated by our simulation can be used to identify strategies for improving patient care. Our approach might helping in understanding and improving the management of patients beyond CSU.
(© 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
Databáze: MEDLINE
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