罕见病患者倡导团体正在做些什么来减轻差异的影响

Debbie Drell, Ashanthi De Silva, Cornelia Lee
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摘要

与影响更多人群的慢性病相比,罕见病患者在诊断、护理和研究方面存在很大的不公平。在RD中,健康差距加剧了这些不平等,因为边缘化社区在获得临床护理方面遇到了额外的障碍,而且在参与研究和临床试验方面的代表性往往不足。近40年来,国家罕见疾病组织(NORD)是一个拥有300多名非营利组织成员的研发伞式组织,通过创新的研究、规划以及与患者、护理人员、从业者和外部利益相关者的合作,领导人们努力了解和解决研发社区的不平等问题。2020年新冠肺炎大流行的开始揭示了边缘化社区长期存在的差异和歧视,以及关键的种族正义运动。这些活动激发了许多RD非营利组织对增加RD内少数族裔社区的外联和参与以及在内部使其组织多样化的兴趣。在对多样性、公平性和包容性(DEI)日益增长的兴趣的基础上,挪威研发部专注于收集挪威研发部及其成员组织内部的案例研究,以了解当前在研发生态系统中改善DEI的努力。临床医生减轻差异影响的一种方法是与RD患者组织合作;这篇文章提供了一种方法,临床医生和研究人员可以通过这种方法了解RD非营利组织在弥合差距方面面临的一些挑战,并了解在其社区内支持边缘化患者的解决方案。鼓励临床医生加入NORD的政策努力,倡导确保患者能够获得与远程医疗不同状态的医疗服务提供者。
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What Rare Disease Patient Advocacy Groups Are Doing to Mitigate the Effects of Disparities
Compared with chronic diseases affecting larger populations, rare disease (RD) patients experience great inequities in diagnosis, care, and research. Within RDs, health disparities compound these inequities, as marginalized communities experience additional barriers in accessing clinical care and are often underrepresented from participation in research and clinical trials. For almost 40 years, the National Organization for Rare Disorders (NORD), a RD umbrella organization with over 300 nonprofit organizational members, has led efforts to understand and address inequities for the RD community through innovative research, programming, and collaboration with patients, caregivers, practitioners, and external stakeholders. The beginning of the COVID-19 pandemic in 2020 brought to light longstanding disparities and discrimination for marginalized communities as well as pivotal racial justice movements. These events spurred many RD nonprofit organizations’ interest in increasing outreach and engagement with minoritized communities within RDs and diversifying their organization internally. Building on the increased interest in diversity, equity, and inclusion (DEI), NORD has focused on collecting case studies from within NORD and its member organizations to capture current efforts to improve DEI within the RD ecosystem. One way clinicians can work to mitigate the effects of disparities is to collaborate with RD patient organizations; this article provides a means by which clinicians and researchers can understand some of the challenges RD nonprofit organizations face in bridging disparities and learn about solutions to supporting marginalized patients within their communities. Clinicians are encouraged to join NORD in our policy efforts advocating to ensure patient access to health care providers practicing in a different state vis-à-vis telehealth.
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