Assessment of American College of Rheumatology–Endorsed Quality Indicators in Rheumatoid Arthritis Patients

Anderson, Erik; Bajaj, Pramila; Raghavan, Siddharth; Patnaik, Asha; Roppelt, Heidi

doi:10.1097/rhu.0000000000000323

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Some studies have described that institution and adherence to T2T guidelines occurred shortly following their appearance, attributing favorable control of disease activity and remission rates to this strategy, which was substantiated by an annual overview prior to and shortly after publication [38]. A retrospective chart review study has previously shown that disease activity and functional assessments increased in number from 2010 to 2012, with excellent treatment and management adherence to quality indicators [41]. In a recent systematic review of real-world T2T evidence [13], it has been shown that over time the rates of achieving remission have gradually improved, though this cannot be attributed to T2T alone.…”

Section: Lag Time In Real-world Institution Of Practice Guidelinesmentioning

confidence: 99%

Physician Adherence to Treat-to-Target and Practice Guidelines in Rheumatoid Arthritis

Batko

Krzanowski

et al. 2019

JCM

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Principles of treat-to-target (T2T) have been widely adopted in both multinational and regional guidelines for rheumatoid arthritis (RA). Several questionnaire studies among physicians and real-world data have suggested that an evidence–practice gap exists in RA management. Investigating physician adherence to T2T, which requires a process measure, is difficult. Different practice patterns among physicians are observed, while adherence to protocolized treatment declines over time. Rheumatologist awareness, agreement, and claims of adherence to T2T guidelines are not always consistent with medical records. Comorbidities, a difficult disease course, communication barriers, and individual preferences may hinder an intensive, proactive treatment stance. Interpreting deviations from protocolized treatment/T2T guidelines requires sufficient clinical context, though higher adherence seems to improve clinical outcomes. Nonmedical constraints in routine care may consist of barriers in healthcare structure and socioeconomic factors. Therefore, strategies to improve the institution of T2T should be tailored to local healthcare. Educational interventions to improve T2T adherence among physicians may show a moderate, although beneficial effect. Meanwhile, a proportion of patients with inadequately controlled RA exists, while management decisions may not be in accordance with T2T. Physicians tend to be aware of current guidelines, but their institution in routine practice seems challenging, which warrants attention and further study.

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Section: Lag Time In Real-world Institution Of Practice Guidelinesmentioning

confidence: 99%

Physician Adherence to Treat-to-Target and Practice Guidelines in Rheumatoid Arthritis

Batko

Krzanowski

et al. 2019

JCM

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“…Development of these measures has identified gaps in care, which is associated with negative effects on health-related quality of life [15–18]. Recognized gaps in care led to informed quality improvement projects that increased physician adherence to treat to target strategies and use of disease activity measures in rheumatoid arthritis [19]. …”

Section: Discussionmentioning

confidence: 99%

Rheumatologists’ perception of systemic lupus erythematosus quality indicators: significant interest and perceived barriers

et al. 2016

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Introduction/objectives Differences in quality of care may contribute to health disparities in systemic lupus erythematosus (SLE). Studies show low physician adherence rates to the SLE Quality Indicators but do not assess physician perception of SLE Quality Indicators or quality improvement. Method Using a cross-sectional survey of rheumatologists in the Southeastern United States, we assessed the perception and involvement of rheumatologists in quality improvement and the SLE Quality Indicators. Using electronic mail, an online survey of 32 questions was delivered to 568 rheumatologists. Results With a response rate of 19% (n = 106), the majority of participants were male, Caucasian, with over 20 years of experience, and seeing adult patients in an academic setting. Participants had a positive perception toward quality improvement (81%) with a majority responding that the SLE Quality Indicators would significantly impact quality of care (54%). While 66% of respondents were familiar with the SLE Quality Indicators, only 18% of respondents reported using them in everyday practice. The most commonly reported barrier to involvement in quality improvement and the SLE Quality Indicators was time. Conclusions Rheumatologists had a positive perception of the SLE Quality Indicators and agreed that use of the Quality Indicators could improve quality of care in SLE; however, they identified time as a barrier to implementation. Future studies should investigate methods to increase use of the SLE Quality Indicators.

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“…Adherence to national and international guidelines certainly increases the quality aspect of effectiveness and improve safety issues (2). Additional quality goals include patient safety, timely and patient-centered care, as well as effective, efficient and socially fair health care (1,(3)(4)(5)(6)(7)(8)(9)(10)(11). An expanded view of quality issues may also contribute to more attractive health care providers' work areas.…”

Section: Introductionmentioning

confidence: 99%

Identification of Five Quality Needs for Rheumatology (Text Analysis and Literature Review)

Pallua

Schirmer

2021

Front. Med.

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Background: While the use of the term “quality” in industry relates to the basic idea of making processes measurable and standardizing processes, medicine focuses on achieving health goals that go far beyond the mere implementation of diagnostic and therapeutic processes. However, the quality management systems used are often simple, self-created concepts that concentrate on administrative processes without considering the quality of the results, which is essential for the patient. For several rheumatic diseases, both outcome and treatment goals have been defined. This work summarizes current mainstreams of strategies with published quality efforts in rheumatology.Methods: PubMed, Cochrane Library, and Web of Science were used to search for studies, and additional manual searches were carried out. Screening and content evaluation were carried out using the PRISMA-P 2015 checklist. After duplicate search in the Endnote reference management software (version X9.1), the software Rayyan QCRI (https://rayyan.qcri.org) was applied to check for pre-defined inclusion and exclusion criteria. Abstracts and full texts were screened and rated using Voyant Tools (https://voyant-tools.org/). Key issues were identified using the collocate analysis.Results: The number of selected publications was small but specific (14 relevant correlations with coefficients >0.8). Using trend analysis, 15 publications with relative frequency of keywords >0.0125 were used for content analysis, revealing 5 quality needs. The treat to target (T2T) initiative was identified as fundamental paradigm. Outcome parameters required for T2T also allow quality assessments in routine clinical work. Quality care by multidisciplinary teams also focusing on polypharmacy and other quality aspects become essential, A global software platform to assess quality aspects is missing. Such an approach requires reporting of multiple outcome parameters according to evidence-based clinical guidelines and recommendations for the different rheumatic diseases. All health aspects defined by the WHO (physical, mental, and social health) have to be integrated into the management of rheumatic patients.Conclusion: For the future, quality projects need goals defined by T2T based initiatives in routine clinical work, secondary quality goals include multidisciplinary cooperation and reduction of polypharmacy. Quality indicators and standards in different health systems will provide new information to optimize patients' care in different health systems.

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Assessment of American College of Rheumatology–Endorsed Quality Indicators in Rheumatoid Arthritis Patients

Cited by 4 publications

References 15 publications

Physician Adherence to Treat-to-Target and Practice Guidelines in Rheumatoid Arthritis

Physician Adherence to Treat-to-Target and Practice Guidelines in Rheumatoid Arthritis

Rheumatologists’ perception of systemic lupus erythematosus quality indicators: significant interest and perceived barriers

Identification of Five Quality Needs for Rheumatology (Text Analysis and Literature Review)

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