AB1313 Systematic screening of comorbidities in chronic inflammatory rheumatic diseases in daily practice: a retrospective monocentric french study according to recent eular guidelines

Abstract

BackgroundIn chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are more frequently observed than in general population and are suboptimally prevented, screened and managed.1–4 A nurse-led programme demonstrated the short-term benefit on management of comorbidities in rheumatoid arthritis patients.5 EULAR recently published points to consider for reporting, screening, and preventing specific comorbidities in chronic inflammatory rheumatic diseases in daily practice.ObjectivesOur objective was to screen and report comorbidities in chronic inflammatory rheumatic diseases patients in daily practice according to recent EULAR guidelines.MethodsWe included patients with rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis from November 2016 to November 2017 in a retrospective monocentric study in the rheumatology department of the Grenoble Alpes Teaching Hospital. Data regarding comorbidities were collected in a standardised multidisciplinary consultation with a rheumatologist, a specialised nurse and a hospital pharmacist, according to EULAR and French Society of Rheumatology guidelines. Data concerning cardiovascular diseases, infectious comorbidities, cancer screening, and osteoporosis were collected. Data about the rheumatic disease including treatment and disease activity were recorded. Adherence was analysed in consultation by the pharmacist. Recommendations were notified to the patients, his general practitioner, and rheumatologist on a standardised letter. Data were analysed as mean/SD if appropriate and percentage.ResultsWe included 101 patients, 43 patients had rheumatoid arthritis, 45 had spondyloarthritis, and 13 were diagnosed with psoriatic arthritis. The mean age was 49,6 years old.14,9 50 patients were followed in the hospital, 39 were followed by private practitioners and 12 were followed by both. All patients were treated with bDMARDS. In average, patients received 2,3 (SD 1,6) different biologic treatments. In our total population, 55,5% had influenza vaccination >1 year ago, 42,6% had an appointment to the dermatologist >1 year ago, 25% of the women between 50 and 75 years old had a mammography >2 years ago and 27,3% of women>50 years old with FRAX above threshold were not treated for osteoporosis. Moreover, 60,5% of patients with rheumatoid arthritis had a Heart Score >1% and 45,6% in the total population.ConclusionsOur monocentric study confirmed that comorbidities are frequent and suboptimally prevented and managed according to the EULAR point to consider. An evaluation of the efficiency of our standardised consultation and intervention is necessary.References[1] Baillet A, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Ann Rheum Dis. 2016, 75(6):965–73[2] Dougados M, et al. COMORA. Ann Rheum Dis. 2014, 73(1):62–8[3] Gossec L, et al. Collection and management of selected comorbidities and their risk factors in...