1. High Adherence to System-Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years
- Author
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Claire E H, Barber, Orit, Schieir, Diane, Lacaille, Deborah A, Marshall, Cheryl, Barnabe, Glen, Hazlewood, J Carter, Thorne, Vandana, Ahluwalia, Susan J, Bartlett, Gilles, Boire, Boulos, Haraoui, Carol, Hitchon, Edward, Keystone, Diane, Tin, Janet E, Pope, Lisa, Denning, Vivian P, Bykerk, and Raman, Joshi
- Subjects
Adult ,Male ,musculoskeletal diseases ,Canada ,medicine.medical_specialty ,Percentile ,Time Factors ,Arthritis ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,System level ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,skin and connective tissue diseases ,Prospective cohort study ,Aged ,030203 arthritis & rheumatology ,business.industry ,Process Assessment, Health Care ,Middle Aged ,medicine.disease ,Antirheumatic Agents ,Rheumatoid arthritis ,Cohort ,Female ,Observational study ,Guideline Adherence ,business ,Early arthritis - Abstract
To assess adherence to 3 system-level performance measures in a national early rheumatoid arthritis (RA) cohort.Patients enrolled in the Canadian Early Arthritis Cohort (2007-2015) who met 1987 or 2010 American College of Rheumatology/European League Against Rheumatism criteria with1 year of symptom duration and ≥1 year of followup after enrollment were included. Performance measures assessed were the percentage of RA patients seen in yearly followup, and the number of gaps between visits of12 or14 months, the percentage of RA patients treated with a disease-modifying antirheumatic drug (DMARD), and days from RA diagnosis to initiation of a DMARD. Results are shown stratified by enrollment year to assess for temporal changes in performance.A total of 1,763 early RA patients were included (mean age 54 years, 73% female, and 82% white). At enrollment, mean ± SD disease duration was 6 ± 3 months, and Disease Activity Score in 28 joints was 5.1 ± 1.5. Over 8 years, the proportion of patients seen in annual followup declined from 100% to 91%. Over followup, 42% of patients had 0 gaps in care of12 months, and 64% had 0 gaps14 months. The percentage of DMARD-treated early RA patients was and remained high (95-87%), and the percentage receiving DMARDs within 14 days of diagnosis was 75%. Median time-to-DMARD therapy was 1 day, indicating DMARDs were initiated at diagnosis (90th percentile 93 days).There was evidence of high adherence to system-level performance measures in this early RA cohort following a protocol. Small declines in performance were noted with increasing length of patient followup. Our findings are useful for performance measure benchmarking.
- Published
- 2018