Abstract

Research has shown that comorbidities, one or more additional disorders (or diseases) co-occurring with the primary disease, occur more frequently in patients with chronic inflammatory rheumatic diseases than in the general population, and are sub-optimally prevented, screened for and managed. In order to contribute to improvement, a EULAR task force has developed points to consider for reporting, screening and preventing selected comorbidities in daily practice. The points to consider and the results from the literature that supported their development have been presented at the EULAR conference in Rome in 2015 and have recently been accepted for publication in ARD.

In accordance with the EULAR Standardized Operating Procedures, a multidisciplinary task force from 12 different countries selected six comorbidities (ischemic cardiovascular diseases, malignancies, infections, peptic ulcer, osteoporosis, depression), based on their frequency and severity (e.g. their impact on mortality and disease outcomes) in a first meeting. Results from a systematic literature review of existing recommendations or guidelines on the reporting, screening, or prevention for each of the selected comorbidities guided the second meeting of the task force. In this consensus meeting a reporting form, an extensive list of variables to be collected in order to report history/occurrence of the comorbidity and current treatments, risk factors and screening, or prevention, was decided on. Standardization of the screening for and reporting of comorbidities will enhance implementation across Europe.

The role of patients in the management of their own disease, including the screening for comorbidities, is increasing. Facilitating patients' involvement in their own care requires various activities. Regarding comorbidities, awareness about the points to consider by developing and disseminating a lay version is necessary but is not sufficient.

Tools such as self-administered questionnaires and supporting information can help strategic implementation of the points to consider, particularly if they are supported with further explanation to the patient whilst empowering them to become more actively engaged in comorbidity self-management. Tools however, also need to make sense to the patient, and should be easily administered and results should be easily interpreted. Also, follow-up of results should be clear.

In what way such a tool can be integrated in daily care, what educational materials for patients are necessary, and how concerns for comorbidities can be reduced needs further exploration.