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Abstract Details
Recommendations and quality criteria to improve the early diagnosis of Primary Biliary Cholangitis
GastroenterolHepatol. 2023Dec16:S02105705(23)004922.doi:10.1016/j.gastrohep.2023.12.002. Online ahead of print.
1Servicio de Gastroenterología y Hepatología. Grupo de Investigación Clínica y Traslacional en Enfermedades Digestivas. Instituto de Investigación Valdecilla (IDIVAL). Hospital Universitario Marqués de Valdecilla, Santander, España.
2Especialista en Medicina Familiar y Comunitaria. C.S. Bezana (Cantabria). Coordinadora del grupo de Digestivo de SEMERGEN, España.
3Grupo ATENEA Investigación. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Sant Joan d'Alacant, España. Electronic address: eva.gilh@umh.es.
4Departamento de Psicología de la Universidad Miguel Hernández, Elche, España; Sociedad Española de Calidad Asistencial, España.
5Servicio de Hepatología. Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBEREHD, España.
6Especialista en Medicina Familiar y Comunitaria. Centro de Salud Cuzco (Madrid). Coordinadora del grupo de Patología digestiva y hepática de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC), España.
7Especialista en Medicina Familiar y Comunitaria. Sociedad Española de Medicina General (SEMG), España.
8Grupo ATENEA Investigación. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana. Sant Joan d'Alacant, España; Departamento de Psicología de la Universidad Miguel Hernández, Elche, España; Sociedad Española de Calidad Asistencial, España.
9Sociedad Española de Calidad Asistencial, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer, España.
Abstract
Objective: The study aimed to establish recommendations and quality criteria to enhance the healthcare process of PBC.
Patients and methods: It was conducted using qualitative techniques, preceded by a literature review. A consensus conference involving 5 specialists in the field was held, followed by a Delphi process developed in two waves, in which 30 specialist physicians in Family and Community Medicine, Digestive System and Internal Medicine were invited to participate.
Results: Seven recommendations and 15 sets of quality criteria, indicators and standards were obtained. Those with the highest consensus were "Know the impact on the patient's quality of life. Consider their point of view and agree on recommendations and care" and "Evaluate possible fibrosis at the time of diagnosis and during PBC follow-up, assessing the evolution of factors associated with poor disease prognosis: noninvasive fibrosis (elastography>2.1KPa/year), GGT, ALP and bilirubin annually", respectively.
Conclusions: The implementation of the consensus recommendations and criteria would provide better patient care. The need for multidisciplinary follow-up and an increased role of primary care is emphasized.
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