Background:Autoimmune diseases are chronic inflammatory pathologies of complex etiology and variable clinical expression that usually affect young individuals, generating chronical pain and altering their functionality. Therefore, one of the mainstays of the treatment is to improve the quality of life (QoL) of these patientsObjectives:To determine the impact of a tight control multidisciplinary rheumatologyprogram in the QoL of patients with rheumatoid arthritis (RA), Systemic lupus erythematosus (SLE) and seronegative spondyloarthropathies (SpA).Methods:A analytical quasi-experimental study was conducted were 3812 patients with RA, 590 patients with SLE and 605 patients with SpA were included and followed between February 2015 and December 2016. Two separated measurements of QoL were developed through the EuroQol Five Dimensions Questionnaire (EQ-5D) by time trade-off (TTO) valuation technique and the visual analogue scale valuation technique (EQ-VAS). Sociodemographic characteristics were analyzed with univariate statistic. The impact on QoL was determined by McNemar test and repeated measures analysis of variance (rANOVA)Results:The most affected dimensions of the EQ-5D were pain/discomfort and anxiety/depression, while the least affected was self-care. When comparing each dimension before and after the entry to the tight control program, a significant increase in the proportion of patients that perceive level 1 for each aspect evaluated was found. In addition, significant improvement was found in the global EQ-VAS (table 1)Table 1Percentage of the levels of EuroQol by dimension according to the diagnosisRAN=3812SLEN=590SpAN=605TotalN=5007 Initial (%)Final (%)Initial (%)Final (%)Initial (%)Final (%)Initial (%)Final (%)P- Value Mobility1234354,9255,742,12,259,838,81,445,452,81,856,541,5265,932,41,746,153,40,552,646,410,003Self-care1236137,81,169,129,41,576,921,91,262,736,21,170,128,51,479,219,51,45940,30,767,432,20,30,001Usual activities1234847,94,155,841,32,961,435,82,949,746,53,956,840,82,76830248,647,93,552,245,52,30,001Pain/discomfort12323,353,323,431,754,413,933,250,716,12453,422,53254,11440,348,61119,756,923,525,857,2170,002Anxiety/depression12356,533,410,265,627,5753,935,910,256,133,810,16527,87,166,126,37,656,534,29,360,731,77,60,001Global VAS mean(SD) 68,8(19,8) 70,4(22,6) 72(19,8) 68,8(19,9) 70,5(22,2) 75(18,6) 65,7(20,5) 65,9(21) 0,001Significant statistical differences were found for all the dimensions in each pathology (initial vs final) except:1 Self-care in SLE (p=0,719)2 Usual activities in SpA (p=0,337)3 Anxiety/depression in SpA (p=0,27)4 Global VAS in SpA (p=0,889)Conclusions:The tight control multidisciplinary rheumatology program is an efficient strategy to improve the QoL and the health perception of patients with chronic autoimmune diseases which impacts on the functionality, performance of everyday activities and productivityReference1. Wang L, Wang FS, Gershwin ME. Human autoimmune diseases: A comprehensive update. Journal of Internal Medicine2015;278(2015):369–395. doi:10.1111/joim.1239...
BackgroundThe multidisciplinary adherence team (MAT) is a interprofessional health care group conformed by a general practitioner, a pharmaceutical chemist and a psychologist, which evaluate the patient to provide a simultaneous multidisciplinary approach focused on promoting strategies to improve adherence to treatment in patients with high disease activity of autoimmune or autoinflammatory pathologiesObjectivesTo determine the impact of the MAT group intervention on the disease activity and therapeutic adherence of Colombian patients with rheumatoid arthritis (RA) and seronegative spondyloarthropathies (SpA).MethodsA quasi-experimental analytical study was performed where 4.921 RA and 756 SpA patients were analysed, of which 395 and 90 respectively presented high persistent disease activity (from moderate to severe persistent), despite of conventional strategies implemented; therefore they underwent intervention by the MAT group between January and December of 2016. Clinical disease activity according to each disease (DAS28 and BASDAI measurements respectively) and adherence level (categories through the Morisky-Green test: no adherence, partial adherence, total adherence) were measured before and after the MAT intervention. The impact on disease activity and adherence level was determined through the McNemar test for independent samplesResultsA significant increase in the proportion of patients in total adherence level was found for both diseases when comparing the initial and final measurements after the intervention by the MAT (table 1). Furthermore, statistical significant differences in the disease activity level were found, identifying a reduction in the proportion of patients with moderate to severe disease activity (Graph 1, A and B) after the MAT interventionAbstract THU0662 – Table 1Impact in adherence in patients with RA and SpA underwent by the MAT group interventionTreatment adherence (Morisky-Green test) ARn=395SpAn=90 Initial (%)Final (%)P-valueInitial (%)Final (%)P-valueNo adherence9,18,1<00017,82,20002Partial Adherence40,832,937,840Total Adherence50,15954,457,8Figure 1 A) Disease Activity in patients whit RA (DAS28); B) Disease Activity in patients whit SpA (BASDAI)ConclusionsThe intervention by the MAT interprofessional group is an efficient strategy impacting the disease activity and therapeutic adherence of RA and SpA patients, improving their clinical outcomes and the natural history of the disease. These findings are relevant and may highlight the potential benefits for the implementation of this approach in patients with devastating autoimmune diseases.Disclosure of InterestNone declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.