Background Scientific progress and better disease awareness constantly lead to increasing patient numbers in rheumatology which requires optimization of patient care.
Objectives The aim of this study was to evaluate and to optimize the procedures of patient care in an university-based outpatient rheumatology setting in Berlin, Germany.
Methods One hundred patients with rheumatoid arthritis (80 women, 20 men, mean age 61.2 years, mean disease duration 12.9 years) were independently assessed both by a rheumatologist and via patient-reported self-assessment questionnaires. Current follow-up interval (usually 3 months), patient's perspective on follow-up intervals, signs of disease activity as well as individual patient concerns were recorded. Satisfaction with follow-up intervals was grouped into three categories: too early, just right/optimal, too late.
Results Based on the physicians perspective, 46 patients presented at the optimal time point, 51 too early, and three too late. The patients reported the category “just right” in 82 cases, too early follow-up in 10 cases and too late in 8 cases. Of note, 51% (42 individuals) of all patients with self-reported satisfactory follow-up interval were judged to visit the out-patient department too early by the expert rheumatologist. When taking into account the follow-up interval and optimal satisfactory levels, 62% of patients were concluded to visit the department too early in those revisited after 3–4 months (n=65), and in 12% of those who were seen again after 5–6 months (n=17). 82% of patients in the latter group were judged to revisit just right by the physician.
Conclusions There was a high proportion of overlap in the views on the satisfaction with follow-up intervals between physicians and patients. Especially in patients who were seen every 3–4 months, a high proportion was deemed to could have come later to the out-patient care unit from a purely medical point of view. Here we see a way to stretch the interval to 5–6 months without risking a long-term deterioration in patient care. However, this measure should be flanked by patient education and good collaboration with the general practitioners.
Acknowledgements We thank AbbVie for financial support in the development of measures to optimize out-patient management in patients with rheumatoid arthritis. The sponsor did not influence the scientific results.
Disclosure of Interest None declared