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Patient-Centered Research Priorities for Pulmonary Nontuberculous Mycobacteria (NTM) Infection. An NTM Research Consortium Workshop Report

机译:肺非结核分枝杆菌(NTM)感染的以患者为中心的研究重点。 NTM研究联盟研讨会报告

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摘要

Nontuberculous mycobacteria (NTM) cause an increasingly important chronic and debilitating lung disease in older adults. Diagnosis is often delayed, although awareness among clinicians and patients is increasing. When necessary, treatment often lasts 18–24 months and consists of three or four antibiotics that can have serious side effects. Relapses are common and commonly require resumption of prolonged therapy. Given the need for improved diagnostic techniques and clinical trials to identify new therapies or to improve existing therapies, a group of North American clinicians and researchers formed the NTM Research Consortium (NTMRC) in 2014. The NTMRC recognized the importance of including the patient voice in determining research priorities for NTM. In November 2015, patients, caregivers, patient advocates, clinical experts, and researchers gathered for a 1-day meeting in Portland, Oregon funded by the Patient-Centered Outcomes Research Institute. The meeting goal was to define patient-centered research priorities for NTM lung infections. Patients expressed frustration with the number of people who have endured years of missed diagnoses or inadequate treatment of NTM. Participants identified as top research priorities the prevention of NTM infection; approval of more effective treatments with fewer side effects and easier administration; understanding the best chest physiotherapy methods; validating and using tools to measure quality of life; and developing a disease-specific activity and severity assessment tool. Workshop participants agreed that two complementary objectives are critical to ensure the best achievable outcomes for patients: (1) additional clinician education to improve screening and diagnosis of NTM infections; and (2) development of a geographically distributed network of experts in NTM disease to offer consultation or direct therapy after a diagnosis is made.
机译:非结核分枝杆菌(NTM)在老年人中引起越来越重要的慢性和使人衰弱的肺部疾病。尽管临床医生和患者的意识正在增强,但诊断通常会延迟。必要时,治疗通常持续18-24个月,由三种或四种可能引起严重副作用的抗生素组成。复发很常见,通常需要恢复长期治疗。鉴于需要改进的诊断技术和临床试验来识别新疗法或改善现有疗法,因此,一群北美临床医生和研究人员于2014年成立了NTM研究联盟(NTMRC)。NTMRC认识到将患者的声音纳入研究的重要性确定NTM的研究重点。 2015年11月,患者,护理人员,患者倡导者,临床专家和研究人员在俄勒冈州波特兰市召开了为期1天的会议,由患者为中心的结果研究所赞助。会议目标是确定以患者为中心的NTM肺部感染研究重点。患者对遭受NTM误诊或治疗不当多年的人数感到沮丧。与会者将预防NTM感染列为首要研究重点;批准更有效的治疗方法,副作用更少,更易于管理;了解最佳的胸部理疗方法;验证和使用工具来衡量生活质量;并开发针对特定疾病的活动和严重程度评估工具。研讨会的与会者一致认为,两个互补的目标对于确保患者获得最佳的治疗效果至关重要:(1)进行额外的临床医生教育,以改善NTM感染的筛查和诊断; (2)建立地理分布的NTM疾病专家网络,以在诊断后提供咨询或直接治疗。

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