A new paradigm of quality of care in rheumatoid arthritis: how our new therapeutics have changed the game

Desai, Sonali; Solomon, Daniel H.

doi:10.1186/ar4356

Cited by 2 publications

(2 citation statements)

References 8 publications

(8 reference statements)

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“…New studies are thus needed to understand relationships between process-based quality measures and patient outcomes. The results of these studies will guide revisions of current quality measures and the development of new ones, including outcomes-based measures of disease activity and function [ 19 ]. Evolving value-based care delivery models may pose some barriers associated with extra time demands for performing, documenting, and reporting quality measures.…”

Section: Discussionmentioning

confidence: 99%

Influence of Continuing Medical Education on Rheumatologists’ Performance on National Quality Measures for Rheumatoid Arthritis

Sapir¹,

Rusie²,

Greene³

et al. 2015

Rheumatol Ther

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IntroductionIn recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists’ performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits.MethodsTwenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists’ documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence.ResultsMean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts).ConclusionThis pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve performance on national quality measures for RA.Electronic supplementary materialThe online version of this article (doi:10.1007/s40744-015-0018-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Influence of Continuing Medical Education on Rheumatologists’ Performance on National Quality Measures for Rheumatoid Arthritis

Sapir¹,

Rusie²,

Greene³

et al. 2015

Rheumatol Ther

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“…The literature has explicitly criticized the model for its lack of patient-centeredness 10 and its failure to cover chronic and palliative care 11 and raised questions of how to define outcomes in chronic care settings, such as the care of rheumatoid arthritis (RA). 12 However, empirical data have not substantiated this criticism, the model itself, or scientific applications of the model.…”

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confidence: 99%

Value-Based Health Care for Chronic Care: Aligning Outcomes Measurement with the Patient Perspective

Ebbevi

Forsberg

Essén³

et al. 2016

Quality Management in Health Care

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Background:Value-based health care is increasingly used for developing health care services by relating patient outcomes to costs. A hierarchical value scorecard for creating outcome measurements has been suggested: the 3-tier model. The objective of this study was to test the model against the patient's view of value in a chronic care setting.Methods:Semistructured interviews with 22 persons with rheumatoid arthritis were conducted, transcribed, and analyzed using qualitative content analysis. Themes were extracted, and the model was critically applied and revised.Results:The study validates existing dimensions in the model but suggests adding information, social health, predictability, and continuity to make it more useful and representative of patients' preferences.Conclusion:Although the model aims to focus on outcomes relevant to patients, it lacks dimensions important to individuals with rheumatoid arthritis. The data illustrate difficulties in finding patients' preferred outcomes and imply tactics for arriving at meaningful measurements.

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A new paradigm of quality of care in rheumatoid arthritis: how our new therapeutics have changed the game

Cited by 2 publications

References 8 publications

Influence of Continuing Medical Education on Rheumatologists’ Performance on National Quality Measures for Rheumatoid Arthritis

Influence of Continuing Medical Education on Rheumatologists’ Performance on National Quality Measures for Rheumatoid Arthritis

Value-Based Health Care for Chronic Care: Aligning Outcomes Measurement with the Patient Perspective

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