Impact of residential area on the management of rheumatoid arthritis patients initiating their first biologic DMARD

Movahedi, Masoud; Joshi, Raman; Rampakakis, Emmanouil; Thorne, Carter; Cesta, Angela; Sampalis, John S.; Bombardier, Claire

doi:10.1097/md.0000000000015517

Cited by 12 publications

(9 citation statements)

References 12 publications

(11 reference statements)

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“…In a Han Chinese population, note was made that none of the patients had rheumatoid nodules ( 32 ). Rural Canadian patients did not have a higher mean number of comorbidities compared to urban patients ( 47 ).…”

Section: Resultsmentioning

confidence: 83%

“…The proportion of patients with ≥3 joints affected by active disease was similar between rural and urban Zimbabwean patients ( 54 ). Disease Activity Score in 28 joints (DAS28) scores and swollen joint counts were similar between rural and urban patients in Senegal ( 53 ), and tender and swollen joint counts, DAS28 scores, Clinical Disease Activity Index scores, and physician global evaluation scores did not differ between rural and urban Canadian patients ( 47 ).…”

Section: Resultsmentioning

confidence: 98%

“…The search generated 1,160 articles after removal of duplicates, and 138 articles were selected for full‐text review (Figure 1 ). From these, 54 articles were included for data synthesis ( 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ) and are described in Supplementary Table…”

Section: Resultsmentioning

confidence: 99%

“…Gong's study from China reported results of the Short Form 36 health survey physical component summary (PCS) score and mental component summary (MCS) score and total scores as an indication of health‐related quality of life (HRQoL), with rural patients having significantly lower PCS and HRQoL scores, but with no difference in MCS compared to urban patients ( 52 ). In a Canadian study of patients initiating their first biologic medication, HAQ scores, fatigue, and patient global scores were reported for rural and urban population comparisons using 2 different determinations for rural status (by postal code and by Statistics Canada population center), with no significant differences between populations ( 47 ).…”

Section: Resultsmentioning

confidence: 99%

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Global Rural and Remote Patients With Rheumatoid Arthritis: A Systematic Review

Pianarosa

Chomistek

Hsiao

et al. 2022

Arthritis Care & Research

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Objective Rural and remote patients with rheumatoid arthritis (RA) are at risk for inequities in health outcomes based on differences in physical environments and health care access potential compared to urban populations. The aim of this systematic review was to synthesize epidemiology, clinical outcomes, and health service use reported for global populations with RA residing in rural and remote locations. Methods Medline, Embase, HealthStar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library were searched from inception to June 2019 using librarian‐developed search terms for RA and rural and remote populations. Peer‐reviewed published manuscripts were included if they reported on epidemiologic, clinical, or health service use outcomes. Results Fifty‐four articles were included for data synthesis, representing studies from all continents. In 11 studies in which there was an appropriate urban population comparator, rural and remote populations were not at increased risk for RA; 1 study reported increased prevalence, and 5 studies reported decreased prevalence in rural and remote populations. Clinical characteristics of rural and remote populations in studies with an appropriate urban comparator showed no significant differences in disease activity measures or disability, but 1 study reported worse physical function and health‐related quality of life in rural and remote populations. Studies reporting on health service use provided evidence that rural and remote residence adversely impacts diagnostic time, ongoing follow‐up, access to RA‐care–related practitioners and services, and variation in medication access and use, with prominent heterogeneity noted between countries. Conclusion RA epidemiology and clinical outcomes are not necessarily different between rural/remote and urban populations within countries. Rural and remote patients face greater barriers to care, which increases the risk for inequities in outcomes.

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Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Global Rural and Remote Patients With Rheumatoid Arthritis: A Systematic Review

Pianarosa

Chomistek

Hsiao

et al. 2022

Arthritis Care & Research

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“…Previous works have assessed the impact of both the rural character of an area and DMARD use for various demographics in the United States (US) [13][14][15][16]. Looking abroad, urban communities in both Canada and Romania have significantly higher rates of bDMARD use compared to their respective rural counterparts [17,18]. If a similar relationship exists in the United States, it would be important to recognize and develop initiatives to address such a gap.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Peterman¹,

Vashi²,

Govan³

et al. 2022

Cureus

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The American College of Rheumatology guidelines provides a strong recommendation for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) when conventional rheumatoid arthritis treatments fail to meet treatment targets. Although bDMARDs are an effective and important treatment component, access inequalities remain a challenge in many communities worldwide. The purpose of this analysis is to assess nationwide trends in bDMARD access in the United States, with a specific focus on rural and urban access gaps. This study combined multiple county-level databases to assess bDMARD prescriptions from 2015 to 2019. Using geospatial analysis and the Moran's I statistic, counties were classified according to prescription levels to assess for hotspots and coldspots. Analysis of variance (ANOVA) was used to compare significant counties across 49 socioeconomic variables of interest. The analysis identified statistically significant hotspot and coldspot prescription clusters within the United States. Coldspot (Low-Low) clusters with low access to bDMARDs are located predominantly in the rural west North Central region, extending down to Oklahoma and Arkansas. Hotspot (High-High) clusters are seen in urban and metro areas of Wisconsin,

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Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural–urban gap and north–south gradient

et al. 2020

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During the coronavirus disease-2019 (COVID-19) pandemic there were several barriers to treatment access and medication adherence in rheumatoid arthritis (RA) patients. There is no information regarding the RA patient health status in Egypt during the COVID-19. Thus,the aim of this work was to study the impact of the pandemic on RA patients through a patient-reported questionnaire and to determine the influence of gender, geographic regions. This multi-centre study initiated by the Egyptian College of Rheumatology (ECR) was conducted on 1037 RA patients attending rheumatology clinics from 10 governorates. The questionnaire provided covered socio-demographic data, health/disease status, information/knowledge about COVID-19 and medical/family history of the infection. Patients mean age was 44.2 ± 12.3 years;855 females and 182 males; 539(52%) from rural and 497(48%) from urban areas. 41.8% reported a striking difficulty to obtain hydroxychloroquine during the pandemic. The majority (70%) considered maintaining a regular visit to the rheumatologist in addition to remote contact mainly by phone (44.4%) or via WhatsApp (33.1%), in particular among male and urban patients. Urban patients were more likely to be infected by COVID-19 (12.9% vs 6.2%; p < 0.0001) than rural. Northern cities had more patients with suspected COVID-19 (13.9% vs 6.1%; p < 0.0001); was significantly associated with more disease flares (30.8% vs 5.8%) with subsequent change in the RA treatment (20.9% vs 6.4%; p < 0.0001). Patients with RA faced remarkable difficulty to obtain their medications with subsequent change in their disease status. The challenges of the pandemic have hastened changes in the way we deliver health care. Electronic supplementary material The online version of this article (10.1007/s00296-020-04736-9) contains supplementary material, which is available to authorized users.

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Impact of residential area on the management of rheumatoid arthritis patients initiating their first biologic DMARD

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 12 publications

Global Rural and Remote Patients With Rheumatoid Arthritis: A Systematic Review

Global Rural and Remote Patients With Rheumatoid Arthritis: A Systematic Review

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural–urban gap and north–south gradient

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