Background Quality indicators (QIs) are specific and measurable elements of practice that can be used to assess the quality of care by clinicians, managers and public. A set of recommendations is in development by an international task force in order to provide the achievable outcome of “best practice” in patients with rheumatoid arthritis (RA).
Objectives To tested the feasibility to quantify the proposed QIs in patients with RA in clinical practice.
Methods Data from all patients and visits included in METEOR database from Jan 2008 until Jan 2012 were analyzed to describe the assessment of QIs. The QIs we were able to collect were as follows: time to diagnosis since first symptoms onset, number of visits per year, frequency of disease activity assessment measured by any of the accepted scores, frequency of assessment of function (HAQ), proportion of patients in remission (DAS28 <2.6, CDAI ≤2.8 or SDAI ≤3.3), proportion of patients with low disease activity (DAS28 <3.2), and proportion of patients with low HAQ (≤ 0.25 in early RA patients and ≤ 0.5 in established RA patients).
Results Data from 12,487 patients and 46,005 visits were included. Patients’ characteristics are shown in table 1A. Median (IQR) values for time to diagnosis (months) and number of visits per year were 6.0 (2-18) and 2.9 (2.0-4.3), respectively. The assessment of HAQ and at least one of the disease activity indices (DAI) were performed in 48.8% and 87.3% of the visits, respectively. The indices assessed were RAI (45.4%), SDAI (28.6%), CDAI (39.1%), DAS (51.2%) and DAS28 (81.4%). The median (IQR) number of HAQ and DAI (at least one) assessment per year were 1.0 (0.2-2.5) and 2.6 (1.6-4.1), respectively. Table 1B shows the % of patients in remission, patients with low disease activity and patients with low HAQ.
Conclusions In patients with RA, the assessment of disease activity, mostly by DAS28, is performed in the majority of the visits included in METEOR. The majority of proposed QIs could be assessed in the database indicating the feasibility of this set of QIs.
Disclosure of Interest None Declared
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