OBJECTIVE: As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. METHODS: Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0-100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation<6) and strong barriers (≥6) were further analysed in multilevel logistic regression models. RESULTS: Overall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients. CONCLUSIONS: Many problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.

Arthritis Center Medisch Spectrum Twente Enschede The Netherlands PHT University of Twente Enschede The Netherlands

Bone and Joint Research Group Royal Cornwall Hospital Truro UK

Care and Public Health Research Institute Maastricht University Maastricht The Netherlands Department of Internal Medicine Division of Rheumatology Maastricht University Medical Center Maastricht The Netherlands

Center for Translational and Clinical Research Aachen Uniklinik RWTH Aachen University Aachen Germany

Centre for Epidemiology Versus Arthritis Centre for Musculoskeletal Research Faculty of Biology Medicine and Health University of Manchester Manchester Academic Health Science Centre Manchester UK NIHR Manchester Biomedical Research Centre Manchester University NHS Foundation Trust Manchester Academic Health Science Centre Manchester United Kingdom

Clinic of Rheumatology Department of Internal Medicine Medical University Sofia Sofia Bulgaria

Cyprus Society for Rheumatology Nicosia Cyprus

Danish Hospital for Rheumatic Diseases Sonderborg Denmark

Department of Health Economics Corvinus University of Budapest Budapest Hungary Rheumatology Flór Ferenc County Hospital Kistarcsa Hungary

Department of Internal Medicine 3 Division of Rheumatology Medical University Vienna Vienna Austria

Department of Internal Medicine and Rheumatology Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Internal Medicine Division of Rheumatology Maastricht University Medical Center Maastricht The Netherlands

Department of Internal Medicine Tartu University Tartu Estonia

Department of Medicine Lappeenranta Central Hospital Lappeenranta Finland

Department of Rheumatology and Clinical Immunology Charité Universitätsmedizin Berlin Berlin Germany

Department of Rheumatology Diakonhjemmet Hospital Oslo Norway

Department of Rheumatology Erebouni Medical Center Yerevan Armenia

Department of Rheumatology Tel Aviv Medical Center Tel Aviv Israel

Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia

Division of Rheumatology Department of Medicine Medical University of Vienna Vienna Austria

Division of Rheumatology School of Medicine Marmara University Istanbul Turkey

Epidemiology Unit Italian Society for Rheumatology Milan Italy

EULAR Patient Research Partner Zaltbommel The Netherlands

Georgian Young Rheumatologists Union Tbilisi Georgia

Health Services Research Maastricht University Maastricht The Netherlands Care and Public Health Research Institute Maastricht University Maastricht The Netherlands

INSERM Sorbonne Universite Paris Île de France France Rheumatology Hopital Universitaire Pitie Salpetriere AP HP Paris Île de France France

Institute of Rheumatology Department of Rheumatology Charles University Prague Czech Republic

Instituto de Salud Musculoesquelética Madrid Spain

Internal Medicine Medical Science Academy Dushanbe Tajikistan

National Institute of Geriatrics Rheumatology and Rehabilitation Warsaw Poland

Rheumatology Allergy Clinical Immunology University of Crete Thessaloniki Greece

Rheumatology Clinic Medical University of Tirana Tirana Albania

Rheumatology Department of Clinical Sciences Lund University Malmö Sweden

Rheumatology Leiden University Medical Center Leiden The Netherlands

Rheumatology Leiden University Medical Center Leiden The Netherlands Rheumatology Zuyderland Medical Center Heerlen The Netherlands

Rheumatology Pauls Stradina Clinical University Hospital Riga Latvia

Rheumatology Portuguese Institute of Rheumatology Lisbon Portugal

Rheumatology Trinity College Dublin Dublin Ireland

Rheumatology University Hospital Zurich Zurich Switzerland

Rheumatology University Hospitals Leuven Leuven Belgium

Rheumatology University of Belgrade School of Medicine Belgrade Serbia

Section for Outcomes Research Center for Medical Statistics Informatics and Intelligent Systems Medical University of Vienna Vienna Austria

Section for Outcomes Research Center for Medical Statistics Informatics and Intelligent Systems Medical University of Vienna Vienna Austria Internal Medicine 3 Division of Rheumatology Medical University of Vienna Vienna Austria

000      

00000naa a2200000 a 4500

001      

bmc20027659

003      

CZ-PrNML

005      

20210114152212.0

007      

ta

008      

210105s2020 xxk f 000 0|eng||

009      

AR

024    7_

$a 10.1136/annrheumdis-2020-217520 $2 doi

035    __

$a (PubMed)32873554

040    __

$a ABA008 $b cze $d ABA008 $e AACR2

041    0_

$a eng

044    __

$a xxk

100    1_

$a Meisters, Rachelle $u Health Services Research, Maastricht University, Maastricht, The Netherlands r.meisters@maastrichtuniversity.nl. Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

245    10

$a EULAR/eumusc.net standards of care for rheumatoid arthritis: cross-sectional analyses of importance, level of implementation and care gaps experienced by patients and rheumatologists across 35 European countries / $c R. Meisters, P. Putrik, S. Ramiro, M. Hifinger, AP. Keszei, Y. van Eijk-Hustings, AD. Woolf, JS. Smolen, TA. Stamm, M. Stoffer-Marx, T. Uhlig, RH. Moe, M. de Wit, A. Tafaj, V. Mukuchyan, P. Studenic, P. Verschueren, R. Shumnalieva, P. Charalambous, J. Vencovský, M. Varvouni, M. Kull, K. Puolakka, L. Gossec, N. Gobejishvili, J. Detert, P. Sidiropoulos, M. Péntek, D. Kane, CA. Scirè, U. Arad, D. Andersone, M. van de Laar, A. van der Helm-van Mil, P. Głuszko, L. Cunha-Miranda, F. Berghea, NS. Damjanov, M. Tomšič, L. Carmona, C. Turesson, A. Ciurea, S. Shukurova, N. Inanc, SM. Verstappen, A. Boonen, Working group,

520    9_

$a OBJECTIVE: As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. METHODS: Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0-100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation<6) and strong barriers (≥6) were further analysed in multilevel logistic regression models. RESULTS: Overall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients. CONCLUSIONS: Many problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.

650    _2

$a dospělí $7 D000328

650    _2

$a senioři $7 D000368

650    12

$a revmatoidní artritida $7 D001172

650    _2

$a průřezové studie $7 D003430

650    _2

$a ženské pohlaví $7 D005260

650    _2

$a lidé $7 D006801

650    _2

$a mužské pohlaví $7 D008297

650    _2

$a lidé středního věku $7 D008875

650    _2

$a registrace $7 D012042

650    _2

$a revmatologové $7 D000072140

650    _2

$a revmatologie $x normy $7 D012219

650    12

$a standardní péče $7 D059039

650    _2

$a průzkumy a dotazníky $7 D011795

651    _2

$a Evropa $7 D005060

655    _2

$a časopisecké články $7 D016428

655    _2

$a multicentrická studie $7 D016448

655    _2

$a práce podpořená grantem $7 D013485

700    1_

$a Putrik, Polina $u Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.

700    1_

$a Ramiro, Sofia $u Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands.

700    1_

$a Hifinger, Monika $u Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.

700    1_

$a Keszei, Andras P $u Center for Translational & Clinical Research Aachen (CTC-A), Uniklinik RWTH Aachen University, Aachen, Germany.

700    1_

$a van Eijk-Hustings, Yvonne $u Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.

700    1_

$a Woolf, Anthony D $u Bone and Joint Research Group, Royal Cornwall Hospital, Truro, UK.

700    1_

$a Smolen, Josef S $u Division of Rheumatology, Department of Medicine, Medical University of Vienna, Vienna, Austria.

700    1_

$a Stamm, Tanja A $u Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.

700    1_

$a Stoffer-Marx, Michaela $u Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria.

700    1_

$a Uhlig, Till $u Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

700    1_

$a Moe, Rikke Helene $u Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

700    1_

$a de Wit, Maarten $u EULAR Patient Research Partner, Zaltbommel, The Netherlands.

700    1_

$a Tafaj, Argjend $u Rheumatology Clinic, Medical University of Tirana, Tirana, Albania.

700    1_

$a Mukuchyan, Vahan $u Department of Rheumatology, Erebouni Medical Center, Yerevan, Armenia.

700    1_

$a Studenic, Paul $u Department of Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria.

700    1_

$a Verschueren, Patrick $u Rheumatology, University Hospitals Leuven, Leuven, Belgium.

700    1_

$a Shumnalieva, Russka $u Clinic of Rheumatology, Department of Internal Medicine, Medical University-Sofia, Sofia, Bulgaria.

700    1_

$a Charalambous, Paraskevi $u Cyprus Society for Rheumatology, Nicosia, Cyprus.

700    1_

$a Vencovský, Jiří $u Institute of Rheumatology, Department of Rheumatology, Charles University, Prague, Czech Republic.

700    1_

$a Varvouni, Melpomeni $u Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark.

700    1_

$a Kull, Mart $u Department of Internal Medicine, Tartu University, Tartu, Estonia.

700    1_

$a Puolakka, Kari $u Department of Medicine, Lappeenranta Central Hospital, Lappeenranta, Finland.

700    1_

$a Gossec, Laure $u INSERM, Sorbonne Universite, Paris, Île-de-France, France. Rheumatology, Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, Île-de-France, France.

700    1_

$a Gobejishvili, Nino $u Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.

700    1_

$a Detert, Jacqueline $u Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

700    1_

$a Sidiropoulos, Prodromos $u Rheumatology, Allergy, Clinical Immunology, University of Crete, Thessaloniki, Greece.

700    1_

$a Péntek, Márta $u Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary. Rheumatology, Flór Ferenc County Hospital, Kistarcsa, Hungary.

700    1_

$a Kane, David $u Rheumatology, Trinity College Dublin, Dublin, Ireland.

700    1_

$a Scirè, Carlo Alberto $u Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy.

700    1_

$a Arad, Uri $u Department of Rheumatology, Tel-Aviv Medical Center, Tel-Aviv, Israel.

700    1_

$a Andersone, Daina $u Rheumatology, Pauls Stradina Clinical University Hospital, Riga, Latvia.

700    1_

$a van de Laar, Mart $u Arthritis Center @ Medisch Spectrum Twente, Enschede, The Netherlands. PHT, University of Twente, Enschede, The Netherlands.

700    1_

$a van der Helm-van Mil, Annette $u Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

700    1_

$a Głuszko, Piotr $u National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland.

700    1_

$a Cunha-Miranda, Luís $u Rheumatology, Portuguese Institute of Rheumatology, Lisbon, Portugal.

700    1_

$a Berghea, Florian $u Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

700    1_

$a Damjanov, Nemanja S $u Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia.

700    1_

$a Tomšič, Matija $u Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

700    1_

$a Carmona, Loreto $u Instituto de Salud Musculoesquelética, Madrid, Spain.

700    1_

$a Turesson, Carl $u Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden.

700    1_

$a Ciurea, Adrian $u Rheumatology, University Hospital Zurich, Zurich, Switzerland.

700    1_

$a Shukurova, Surayo $u Internal Medicine, Medical Science Academy, Dushanbe, Tajikistan.

700    1_

$a Inanc, Nevsun $u Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.

700    1_

$a Verstappen, Suzanne Mm $u Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.

700    1_

$a Boonen, Annelies $u Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.

710    2_

$a Working group

773    0_

$w MED00000444 $t Annals of the rheumatic diseases $x 1468-2060 $g Roč. 79, č. 11 (2020), s. 1423-1431

856    41

$u https://pubmed.ncbi.nlm.nih.gov/32873554 $y Pubmed

910    __

$a ABA008 $b sig $c sign $y a $z 0

990    __

$a 20210105 $b ABA008

991    __

$a 20210114152210 $b ABA008

999    __

$a ok $b bmc $g 1607994 $s 1118839

BAS    __

$a 3

BAS    __

$a PreBMC

BMC    __

$a 2020 $b 79 $c 11 $d 1423-1431 $e 20200901 $i 1468-2060 $m Annals of the rheumatic diseases $n Ann Rheum Dis $x MED00000444

LZP    __

$a Pubmed-20210105