Multidisciplinary care in patients with systemic lupus erythematosus: a randomized controlled trial in China

Zhang, Le; Geng, Shikai; Qian, Liping; Ye, Shuang; Wang, Xiaodong; Lu, Guohong; Ding, Yang; Li, Ting

doi:10.1007/s11096-019-00870-y

Cited by 6 publications

(20 citation statements)

References 33 publications

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“…For SLE, the largest category of non-pharmacological management was physical exercise and physical activity (n=34), 7 14-45 followed by patient education and self-management (n=21), 13 31 46-64 psychological interventions (n=21), 37 65-84 dietary therapy and nutrition (n=14), 19 85-97 complementary medicine (n=5), [98][99][100][101][102] photoprotection (n=5), [103][104][105][106][107] healthcare models (n=4), [108][109][110][111] laser treatment (n=2), 112 113 social support (n=2) 114 115 and others (n=6). [116][117][118][119][120][121] For SSc, the largest category of non-pharmacological management was, as in SLE, physical exercise and physical activity (n=32), followed by patient education and self-management (n=12), 13 144 148 154-162 bathing and thermal modalities (n=8), 123 136 141-143 163-165 complementary medicine (n=8), 146 163 166-171 manual therapy (n=8), 126 127 129 136 139 172-174 dietary therapy and nutrition (n=6), [175][176][177][178][179][180] phototherapy and laser treatment (n=6), [181][182][183][184][185][186] shockwave therapy (n=4), [187][188]…”

Section: Categories Of Interventions (Rq2)mentioning

confidence: 99%

“…103 Studies on healthcare models were few, non-robust in CA and diverse. [108][109][110][111] Pulsed dye laser on discoid lesions was shown in one quasi-experimental study (CA: robust) to decrease mucocutaneous activity assessed using the Cutaneous Lupus Erythematosus Disease Area and Severity Index. 112 Two cross-sectional studies (CA: robust) found that social support associated with better HRQoL, illness uncertainty and coping skills.…”

Section: Other Categoriesmentioning

confidence: 99%

“…Within the SLE literature selected for analysis, studies on healthcare models were few, non-robust in CA and diverse; thus, no firm conclusions could be drawn regarding the efficacy of healthcare models. [108][109][110][111] Likewise, studies on oral hygiene interventions within the selected SSc literature were few, dissimilar in design and non-robust in CA; thus, no firm conclusions could be drawn regarding their efficacy. 131 191 195 Regarding organ systems for which interventions were evaluated, the gastrointestinal tract emerged as an important healthrelated domain that was often subject to investigation in SSc, but not in SLE.…”

Section: Systemic Sclerosismentioning

confidence: 99%

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Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

et al. 2023

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Through this systematic literature review, we assembled evidence to inform the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). We screened articles published between January 2000 and June 2021. Studies selected for data extraction (118 for SLE and 92 for SSc) were thematically categorised by the character of their intervention. Of 208 articles included, 51 were classified as robust in critical appraisal. Physical activity was the most studied management strategy and was found to be efficacious in both diseases. Patient education and self-management also constituted widely studied topics. Many studies on SLE found psychological interventions to improve quality of life. Studies on SSc found phototherapy and laser treatment to improve cutaneous disease manifestations. In summary, non-pharmacological management of SLE and SSc encompasses a wide range of interventions, which can be combined and provided either with or without adjunct pharmacological treatment but should not aim to substitute the latter when this is deemed required. While some management strategies i.e., physical exercise and patient education, are already established in current clinical practice in several centres, others e.g., phototherapy and laser treatment, show both feasibility and efficacy, yet require testing in more rigorous trials than those hitherto conducted.

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Section: Categories Of Interventions (Rq2)mentioning

confidence: 99%

Section: Other Categoriesmentioning

confidence: 99%

Section: Systemic Sclerosismentioning

confidence: 99%

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Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

et al. 2023

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“…Multidisciplinary teams (MDTs) are the main focus of most studies in this subcategory (18 out of 20 studies) (66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83). An MDT is a team consisting of healthcare professionals from different disciplines that work together to provide better patient care (84).…”

Section: Toolsmentioning

confidence: 99%

What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review

Wang

Buljac-Samardžić

Wang

et al. 2021

Front. Public Health

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Background and Objective: Improving quality of care is one of the primary goals in current Chinese hospital reforms. Teamwork can play an essential role. Characteristics of teamwork and interventions for improving teamwork in hospitals have been widely studied. However, most of these studies are from a Western context; evidence from China is scarce. Because of the contextual differences between China and Western countries, empirical evidence on teamwork from Western hospitals may have limited validity in China. This systematic review aims to advance the evidence base and understanding of teamwork in Chinese hospitals.Methods: Both English (i.e., Embase, Medline, and Web of Science) and Chinese databases (i.e., CNKI, CQVIP, and Wanfang) were searched for relevant articles until February 6, 2020. We included the studies that empirically researched teamwork in Chinese hospitals. Studies were excluded if they (1) were not conducted in hospitals in Mainland China, (2) did not research teamwork on team interventions, (3) were not empirical, (4) were not written in English or Chinese, (5) were not published in peer-reviewed journals, and (6) were not conducted in teams that provide direct patient care. Both deductive and inductive approaches were used to analyze data. The Mixed Methods Appraisal Tool (MMAT) was used to assess their methodological quality.Results: A total of 70 articles (i.e., 39 English articles and 31 Chinese articles) were included. The results are presented in two main categories: Teamwork components and Team interventions. The evidence regarding the relationships among inputs, processes, and outcomes is scarce and mostly inconclusive. The only conclusive evidence shows that females perceive better team processes than males. Similar types of training and tools were introduced as can be found in Western literature, all showing positive effects. In line with the Chinese health reforms, many of the intervention studies regard the introduction of multidisciplinary teams (MDTs). The evidence on the implementation of MDTs reveals that they have led to lower complication rates, shorter hospital stays, higher diagnosis accuracy, efficiency improvement, and a variety of better disease-specific clinical outcomes. Evidence on the effect on patient survival is inconclusive.Conclusion: The Chinese studies on teamwork components mainly focus on the input-process relationship. The evidence provided on this relationship is, however, mostly inconclusive. The intervention studies in Chinese hospitals predominantly focus on patient outcomes rather than organizational and employee outcomes. The introduction of training, tools, and MDTs generally shows promising results. The evidence from primary hospitals and rural areas, which are prioritized in the health reforms, is especially scarce. Advancing the evidence base on teamwork, especially in primary hospitals and rural areas, is needed and can inform policy and management to promote the health reform implementation.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020175069, identifier CRD42020175069.

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“…Clinical pharmacists in hospitals should increase patient medication adherence by logical drug use promotion and enhance drug efficacy and safety monitoring. At the same time, they need to keep an eye on adverse drug reactions and drug-drug interactions, provide timely pharmacological advice to physicians and patients, and improve the level of rational drug use ( Zhang et al, 2019 ). For example, the risk of miscarriage increases with the use of NSAIDs in the first trimester, and they should be avoided in the last stages of pregnancy because they may result in the premature closure of the fetal ductus arteriosus ( Koren et al, 2006 ; Brouwer et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Real-world pharmacological treatment of pregnant patients with rheumatic diseases from China: a retrospective analysis from 2016 to 2021

Jia,

Wang

2024

Front. Pharmacol.

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Introduction: We investigated trends in the use of therapeutic drugs for pregnant patients with rheumatic diseases in nine Chinese cities (Beijing, Chengdu, Guangzhou, Harbin, Hangzhou, Shanghai, Shenyang, Tianjin, and Zhengzhou) to provide a reference for drug use in clinic.Methods: Outpatient prescription data for pregnant patients diagnosed with rheumatic diseases in nine cities across China in 2016–2021 were extracted from the Hospital Prescription Cooperation Project of the Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association. A retrospective analysis was then performed, incorporating data on patient age, defined daily doses (DDDs), defined daily cost (DDC), and other metrics.Results: In 2016–2020, more than 70% of the pregnant patients diagnosed with rheumatic diseases in these nine cities were 25 to < 35 years of age. The most common rheumatic diseases during pregnancy were antiphospholipid antibody syndrome (APS) and systemic lupus erythematosus (SLE). In terms of the routine use of daily therapeutic drugs, the DDDs of low molecular weight heparins (LMWHs), glucocorticoids, and immunosuppressive agents dominated the top three. Intravenous immunoglobulin (IVIG) and tumor necrosis factor inhibitors (TNFi) have been used since 2019 and had been in the forefront of the DDC.Conclusion: The number and total cost of prescriptions for therapeutic drugs of pregnancy complicated by rheumatic diseases, have increased significantly over the study interval. Conventional therapeutic drugs, especially glucocorticoids, LMWHs, and hydroxychloroquine were the most widely used drugs in pregnant patients with rheumatic diseases. However, IVIG and TNFi, relatively high cost, have shown gradual increases in clinical use since 2019.

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Multidisciplinary care in patients with systemic lupus erythematosus: a randomized controlled trial in China

Cited by 6 publications

References 33 publications

Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

Systematic literature review informing the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review

Real-world pharmacological treatment of pregnant patients with rheumatic diseases from China: a retrospective analysis from 2016 to 2021

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