Research and Reports in Pulmonology

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Short Communication - Research and Reports in Pulmonology (2021) Volume 1, Issue 2

Pulmonary sarcoidosis: a multicentre initiative

 

 
Sarcoidosis is a chronic systemic disease of unknown aetiology, characterised histologically by
granulomatous inflammation. Existing treatment options include either no medication or a mix of firstline,
second-line and third-line medication with trade-offs between treating inflammation and quality
of life (QoL). A chronic disease course requires long-term treatment with corticosteroids, cytotoxics
and other agents that can have a serious impact on the quality of life. Significant grey areas exist in
approaches to treatment and thus how care is delivered across different countries and centres. Little
knowledge is available regarding outcomes of delivered care in relation to the various treatment options.
Therefore, there is a need for standardisation of core outcomes to ensure high-value care delivery for
all patients with sarcoidosis globally. Patients suffering from chronic diseases have persistent needs
and therefore need ongoing healthcare. Accordingly, patients with complex chronic conditions, such as
sarcoidosis, are also the costliest patients, and costs increase with the number of chronic conditions. In
patients with sarcoidosis, it has been confirmed they have higher rates of comorbidity and complexity
compared with a matched control group (matched for age and gender). Furthermore, it was found
that the main comorbidities were pulmonary, liver, autoimmune and neoplastic disease in patients
with sarcoidosis compared with controls. It was estimated that commercial payers incurred US$19 714
annually on healthcare costs spent per patient with sarcoidosis in the USA, with outpatient visits and
inpatient admissions as the two main cost drivers. Globally, healthcare providers are driven by similar
goals: to improve patient experiences and healthcare outcomes, to become more efficient and to reduce
the costs as well as to innovate the way care is provided. As addressed by Porter, value-based healthcare
(VBHC) could be a guiding principle in achieving these multiple goals. In particular, transparently
sharing treatment outcomes of routine clinical care can help hospitals to learn from each other and
improve patient value, defined as outcomes over costs. Sarcoidosis often affects young and middle-aged
adults. Patients suffer from a broad range of non-specific symptoms, with high variability in the degree
of inflammation as well as organs affected. In more than 90% of the cases, sarcoidosis affects the lungs.
Spontaneous remissions occur in approximately two-thirds of the patients, but the disease course is
chronic in 10%–30% of the patients. Incidence and prevalence rates reported in the literature are highly
variable. The prevalence varies over geographical regions as well as ethnic groups, with the highest
sarcoidosis prevalence reported in the Nordic countries and in individuals of African descent. For this
study, we aimed to specifically develop a standard set of outcome measures for patients with pulmonary
sarcoidosis.
Author(s): Rennie Medina,

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