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THU0766-HPR Referral to telecare. a new model of rheumatic patient follow-up
  1. L Cano Garcia,
  2. N Mena-Vazquez,
  3. S Manrique-Arija,
  4. FG Jiménez-Núñez,
  5. I Ureña-Garnica,
  6. C Domic-Bueno,
  7. M Rojas-Gimenez,
  8. C Fuegos-Varela,
  9. MV Irigoyen-Oyarzabal,
  10. E Vilchez-Ocaña,
  11. A Fernández-Nebro
  1. Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain

Abstract

Objectives To analyze the medical ramifications that are made to the consultation of telecare of Rheumatology Nursing (CTCER) of our hospital and health care activity generated by this.

Methods Design: Observational study cross.

Patients: 301 patients for follow-up were derived to CTCER in a hospital of third level of January - November 2016. Our hospital serves a population of 600,000 people.

Protocol: We have a specific document for referral to CTCER where the rheumatologist specifies the reason for referral, the nurse review period and diagnosis. Nurse appointment the patient in its agenda for the telephone follow-up on the date indicated and recorded in the history of the patient efforts made the day of the appointment. The most common medical efforts making the nurse are preset by consensus with rheumatologists. Coming out than expected are reviewed with responsible for the patient's rheumatologist.

Variables analyzed: diagnosis, reason shunt type of FAME, adverse events, appearance of Comorbidities, nurse management, new problems after telephone consultation.

Statistical analysis: descriptive analysis of the main variables.

Results Of the 301 patients, 68.4% were women. The diagnoses were: rheumatoid arthritis (RA) 116 (38.5%), spondyloarthropathy (SpA) 34 (11.3%), psoriatic arthritis (PsA) 45 (15%), systemic lupus erythematosus (SLE) (18.9%), vasculitis 1 (0.3%), arthritis juvenile idiopathic (AJI) 5 (1.7%), Still's disease adult 3 (1%), osteoporosis 4 (1.3%), 4 undifferentiated arthritis (1.3%). Them reasons of referral were: control to the month of home of FAME synthetic 120 (39.9%), Control to the home of FAME biological 28 (9.3%), review consultations 110 (36.5%), control toxicity hepatic 17 (5.6%), control alteration hematologic 7 (2.3%), control alteration renal 1 (0.3%), control of security of treatment Mycophenolate 4 (1.3%), control of safety of Teriparatide 6 (2%), wish gestational 1 (0.3%), analytical control not performed in consultation 13 (4.3%) (Table1). The most derived synthetic FAME was methotrexate 174 (57.5%) and the most derived biological FAME was etanercept 16 (5.3%) (table2). Nurse managed bypass autonomously 298 (99%) referrals, need help of the rheumatologist in 2 (0.7%) referrals and having only 1 shunt derived to 2017. 17 (5.6%) leads new problems with the call appeared: intolerance digestive 11 (3.7%), headache 3 (1%), worsening 1 (0.3%), moderate 1 infection (0.3%), poor adhesion 3 (1%), new comorbidity 3 (1%).

Conclusions The inquiry of telecare is a form of collaborative work rheumatologist-nurse. The nurse can manage leads independently without having to go to your rheumatologist. This type of nurse call brings improvements in patient care, prevents displacement, decreased on-site visits and improves the safety of patients.

Disclosure of Interest None declared

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