Subject: Telemedicine
Subject: Treatments
Subject: Health policy
Year: 2019
Type: Article
Title: National advisory services for multidrug-resistant tuberculosis (MDRTB) in Europe: an ERS-TBnet survey
Author: Bothamley, Graham H.
Author: Andre, Emmanuel
Author: Kuksa, Liga
Author: Barkana, Linda
Author: Keane, Joseph
Author: Veziris, Nicolas
Author: Van Crevel, Reinout
Author: Magis-Escurra, Cecile
Author: Jankovic, Mateja
Author: Schoch, Otto
Author: Zellweger, Jean-Pierre
Author: Vasankari, Tuula
Author: Eyuboglu, Fusun
Author: Holland, Regina
Author: Normark, Johan
Author: Macedo, Rita
Author: Korzeniewska, Maria
Author: Nanovic, Zorica
Author: Butov, Dmytro
Author: Akkerman, Onno
Author: Kirakosyan, Ohanna
Author: Solovic, Ivan
Author: Calcagno, Andrea
Author: Kruczak, Katarzyna
Author: Garcia Garcia, Jose Maria
Author: Sanchez Montalva, Adrian
Author: Dyatlov, Alexander
Author: Starshinova, Anna
Author: Kulcitkaia, Stela
Author: Lillebaek, Troels
Author: Wiese, Lothar
Author: Hafizi, Hasan
Author: Papaventis, Dimitros
Author: Heldel, Einar
Author: Arnesen, Trude Marget
Author: Lanoix, Jean-Philippe
Author: Chiappini, Elena
Author: Wejse, Christian
Author: Manika, Kataerina
Author: Pesut, Dragica
Author: Wetzstein, Nils
Author: Skrahina, Alena
Author: Flick, Holger
Author: Arias, Miguel
Author: Konstantynovska, Olha
Author: Millet, Joan Pau
Author: Bakker, Marleen
Author: Lange, Christoph
Abstract: Introduction: Treatment of MDRTB is complex: regimens require microbiological data; adverse events are frequent; availability of drugs and authorization for new drugs varies. The aim of this study was to scope the available national resources. Method: A survey to determine whether practising physicians could access MDRTB advice was sent to TBnet members by email. The ERS Office also contacted national respiratory societies. Questions included the name and contact details for their national advisory service, whether it was national policy to use the service for each patient with MDRTB and whether advice was required to access bedaquiline and delaminid. Results: 65 replies were received (14 were uninformative). 26/31 EU/EEA and 10/19 other countries in the WHO European Region were represented. 7 countries referred all MDRTB to a tertiary centre; 12 countries had tertiary referral centres that also gave advice to physicians treating MDRTB. 11 countries had an electronic system for advice, 6 with multidisciplinary team meetings to review patients’ progress. Lead clinicians were identified for a further 8 countries, one of which had no national advisory service and the other 7 had not responded by the time of abstract submission. For 18 (58%) countries, discussion of MDRTB by a national /regional committee was national policy and most (15/18) required consultation to use bedaquiline or delamanid. Electronic platforms had a wide range of functionality but few retained anonymised data and audited patient outcomes. Conclusion: MDRTB management is often concentrated in tertiary centres. Clinical governance, regarding audit and outcome, are at an early stage in managing MDRTB.
Publisher: European Respiratory Society
Relation: European Respiratory Journal
Identifier: oai:repository.ukim.mk:20.500.12188/9218
Identifier: http://hdl.handle.net/20.500.12188/9218Identifier: 10.1183/13993003.congress-2019.pa5285
Identifier: https://syndication.highwire.org/content/doi/10.1183/13993003.congress-2019.PA5285
