Considerations for improving quality of care of patients with rheumatoid arthritis and associated comorbidities
Language English Country Great Britain, England Media print
Document type Journal Article
PubMed
32683326
PubMed Central
PMC7722279
DOI
10.1136/rmdopen-2020-001211
PII: rmdopen-2020-001211
Knihovny.cz E-resources
- Keywords
- Arthritis, Autoimmune diseases, Rheumatoid Arthritis,
- MeSH
- Comorbidity MeSH
- Quality of Health Care * MeSH
- Humans MeSH
- Delivery of Health Care MeSH
- Prevalence MeSH
- Arthritis, Rheumatoid epidemiology pathology MeSH
- Self-Management MeSH
- Quality Assurance, Health Care MeSH
- Quality Improvement * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder with a global prevalence of approximately 0.5-1%. Patients with RA are at an increased risk of developing comorbidities (eg, cardiovascular disease, pulmonary disease, diabetes and depression). Despite this, there are limited recommendations for the management and implementation of associated comorbidities. This study aimed to identify good practice interventions in the care of RA and associated comorbidities. METHODS: A combination of primary research (180+ interviews with specialists across 12 European rheumatology centres) and secondary research (literature review of existing publications and guidelines/recommendations) were used to identify challenges in management and corresponding good practice interventions. Findings were prioritised and reviewed by a group of 18 rheumatology experts including rheumatologists, comorbidity experts, a patient representative and a highly specialised nurse. RESULTS: Challenges throughout the patient pathway (including delays in diagnosis and referral, shortage of rheumatologists, limited awareness of primary care professionals) and 18 good practice interventions were identified in the study. The expert group segmented and prioritised interventions according to three distinct stages of the disease: (1) suspected RA, (2) recent diagnosis of RA and (3) established RA. Examples of good practice interventions included enabling self-management (self-monitoring and disease management support, for example, lifestyle adaptations); early arthritis clinic; rapid access to care (online referral, triage, ultrasound-guided diagnosis); dedicated comorbidity specialists; enhanced communication with primary care (hotline, education sessions); and integrating patient registries into daily clinical practice. CONCLUSION: Learning from implementation of good practice interventions in centres across Europe provides an opportunity to more widely improved care for patients with RA and associated comorbidities.
Cliniques Universitaires Saint Luc UCL Brussels Belgium
Department of Internal Medicine Specialties University Hospitals of Geneva Geneva Switzerland
Dept of Rheumatology Diakonhjemmet Hospital Oslo Norway
Global Strategy Group KPMG LLP London UK
Hôpital Cochin Rheumatology Université Paris Descartes Paris France
Hospital De Santa Maria Lisboa Portugal
Hospital Universitario La Paz Madrid Spain
Leeds Institute of Rheumatic and Musculoskeletal Medicine Chapel Allerton Hospital Leeds UK
Neil Betteridge Associates London UK
Radboud University Medical Center Nijmegen Nijmegen Netherlands
Rheumatologic Clinic Institute of Rheumatology Prague Czech Republic
Rheumatology Gaetano Pini Institute Milan Italy
Rheumatology Karolinska Institutet Stockholm Sweden
Salisbury NHS Foundation Trust Salisbury UK
Sint Maartenskliniek Nijmegen Netherlands
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