Background: Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases. Objective: We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach. Methods: We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis. Results: We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p<0.005), including the evaluation of rheumatoid factor, Anti-citrullinated antibodies Disease Activity Score, Health Assessment Questionnaire, number of visits to the rheumatologist, and clinical outcomes measured by the level of disease activity. In addition, when comparing the Center's clinical outcomes-from baseline to the last follow-up, we found an improvement in the level of disease activity, with patients classified in remission increasing from 20.8% to 58.5% (p<0.005), and a reduction in those with high disease activity from 18% to 4.7% (p<0.005). Conclusion: Real-world evidence showed that patients with rheumatoid arthritis who underwent follow-up under an innovative disease-management model improved their clinical outcomes compared with those patients in a conventional assessment program. These results could suggest a way of improving health policies for patients with rheumatoid arthritis.
This study evaluated a non-face-to-face-multidisciplinary consultation model in a population with rheumatoid arthritis (RA) during the COVID-19 pandemic. This is an analytical observational study of a prospective cohort with simple random sampling. RA patients were followed for 12 weeks (Jul–Oct 2020). Two groups were included: patients in telemedicine care (TM), and patients in the usual face-to-face care (UC). Patients could voluntarily change the care model (transition model (TR)). Activity of disease, quality of life, disability, therapeutic adherence, and self-care ability were analyzed. Bivariate analysis was performed. A qualitative descriptive exploratory study was conducted. At the beginning, 218 adults were included: (109/TM-109/UC). The groups didn’t differ in general characteristics. At the end of the study, there were no differences in TM: (n = 71). A significant (p < 0.05) decrease in adherence, and increase in self-care ability were found in UC (n = 18) and TR (n = 129). Seven patients developed COVID-19. Four categories emerged from the experience of the subjects in the qualitative assessment (factors present in communication, information and communication technologies management, family support and interaction, and adherence to treatment). The telemedicine model keeps RA patients stable without major differences compared to the usual care or mixed model.
BackgroundIt is difficult to make a differential diagnosis between seronegative RA and other inflammatory arthropathies. Many patients could be wrong diagnosed followed of expensives treatments.ObjectivesTo assess the usefulness of X-rays of hands and feet (X-rays), Ultrasound (US) and Magnetic Resonance Imaging (MRI) to discard false positive diagnosis of seronegative RA from real-world evidence.MethodsAn analysis from medical records of patients with presumptive seronegative RA diagnosis reportedly seronegative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies and clinical criteria of RA, in the period between July 2016 and ; June of 2017 who were assesed by imagenology (X-rays, US or MRI) in a centre of rheumatoid arthritis to confirm diagnosis or discard it. Laboratory, and imagenology data was retrospectively analysed and multivariate analysis was performed to determinate the usefulness of imagenology.Results360 patients were received in the centre with presumptive diagnosis of RA in the period, mean of age was 58 years, 80,9% females and 19,1% males. X-rays shows only 3,59% of patients with erosions, 38,6% were positive for Ostheoarthritis (OA), and 58,6% of patients without erosions. From patients without erosions, 36% were confirmed for RA and 13,4% for OA by US; on the other hand 37% was confirmed for RA and 20% for OA by MRI. A total of 94 patients (26,1%) had a final diagnosis of seronegative RA, while (261) patients 72,5% were confirmed for Osteoarthrosis,5 1,4% were classified in other arthropaties.ConclusionsAccording with our findings the screening by imagenology is a useful tool with low cost to make a differential diagnosis of seronegative RA and other arthropaties. In order to improves outcomes through well-defined treatments and to save high cost treatments for pathologies with more precise diagnoses.Disclosure of InterestNone declared
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