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SAT0440 Health care quality indicators for rheumatoid arhtritis and osteoarthritis: The eumusc.net project
  1. I.F. Petersson1,
  2. B. Strömbeck1,
  3. T. Stamm2,
  4. T. Uhlig3,
  5. A.D. Woolf4,
  6. T. Vliet Vlieland5
  7. and the EUMUSC.NET WP6 Group
  1. 1Clinical Sciences Lund, Lund University, Sweden, Musculoskeletal Research Centre, Lund, Sweden
  2. 2Medizinisches Universität, Vienna, Austria
  3. 3Diakonhjemmets sykehus, Oslo, Norway
  4. 4Rheumatology, Royal Cornwal Hospital, Truro, United Kingdom
  5. 5LUMC, Leiden, Netherlands

Abstract

Background EUMUSC.Net (www.eumusc.net) is a European project supported by the EU and EULAR to develop patient centered Standards of Care (SOC) and Health Care Quality Indicators (HCQIs) for rheumatoid arthritis (RA) and osteoarthritis (OA)

Objectives To develop Health Care Quality Indicators (HCQIs) for health care provision for RA and OA based on existing HCQI literature evidence and SOCs

Methods Based on a formal literature search already existing HCQIs for RA and OA were identified. Topics from HCQIs for OA and RA found in the literature were sorted according to SOCs developed within the EUMUSC.Net (OA n=12, RA n=16).

During three physical meetings and e-mail contacts with different health professionals and patient representatives topics were added or modified. Repeated Delphi processes were performed to rank the topics, phrase/rephrase suggested HCQIs and to assess Strength of Recommendation (SOR).

After an audit process by rheumatology and primary health care units (including academic centres) in December 2011 in UK, Netherlands, Norway, Romania, Italy Austria, and Sweden final versions of the HCQIs were presented

Results The final set of HCQIs for RA (n=14) include 2 for structure, 11 for process and 1 for outcome. Example structure indicator: “Rheumatology practices should have the facilities to at least annually calculate and record (electronically or on paper) composite scores like DAS 28 or any of its variants CDAI or SDAI, for all patients with RA”

Example for process indicator: “If a patient is newly diagnosed with RA, then, he or she should be given individually tailored education by relevant health professionals about the natural history, treatment, and self management of the disease within 3 months”.

Example outcome indicator: “If a patient is diagnosed with active RA (i.e. DAS 28 over 3.2) then the disease activity should be low (i.e. DAS28 below 3.2) 6 months after treatment has started”.

The final set for OA (n=12) include 2 for structure, 8 for process and 2 for different outcomes.

Example structure indicator: “All professionals managing patients with OA at a primary health care centre should have continuous access to education on important preventive and therapeutic strategies in the management of OA”.

Example process indicator: “If a patient with OA is overweight (as defined by a BMI >27), then he or she should receive information on weight management and offered referral to a weight management program”.

Example outcome indicator: “If a patient is diagnosed with symptomatic OA and has functional limitation then an improvement of his/her functional ability by 20% on a patient reported outcome measure should be reached within three months after initiation/change of pharmacological/non pharmacological treatment”.

Conclusions Using existing guidelines and SOCs a further step is needed to identify corresponding HCQIs to encourage their implementation. We now suggest sets of HCQIs for RA and OA which can be used in quality improvement and bench marking in and between indivudual countries accross Europe.

Disclosure of Interest None Declared

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