Naranjo Antonio, Cáceres Laura, Hernández-Beriaín José Ángel, Francisco Félix, Ojeda Soledad, Talaverano Sigrid, Nóvoa-Medina Javier, Martín José Adán, Delgado Esmeralda, Trujillo Elisa, Álvarez Fátima, Magdalena Laura, Rodríguez-Lozano Carlos
Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, España. Universidad de Las Palmas de Gran Canaria, Gran Canaria, España.
Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, España. Universidad de Las Palmas de Gran Canaria, Gran Canaria, España.
Reumatol Clin. 2016 Jan-Feb;12(1):34-8. doi: 10.1016/j.reuma.2015.03.003. Epub 2015 Apr 11.
To analyze compliance with t2t clinical practice guidelines.
Cross-sectional observational study in consecutive patients with rheumatoid arthritis (RA) in 5 hospitals in the Canary Islands. Patients filled out activity scales, HAQ and answered the question of whether the doctor had explained the treatment target. The rheumatologist also collected: visits in the past year, use of activity indices and HAQ, DAS28 of current visit and date of the next visit. The percentage of compliance to indicators based on the t2t recommendations (R) 1, 3, 5-7 and 10 was analyzed.
A total of 343 patients were recruited, 77% female, mean age 57, RA duration of 10 years. Median visits in the last year were 3 and mean time between last and current visit was 5.6 months. A total of 93% of the patients were treated with DMARDs and 44% were in remission by DAS (R1). In the previous visit, documented joint count was present in 85%, a HAQ in 19%, patient VAS in 41%, and a DAS28 in 35% of the patients (R6). The next visit was scheduled at an average of 4.3 months (R5). In 64% of patients with DAS28> 3.2 a visit between one and 3 months was scheduled (R5). A total of 96% of patients said they had been informed of the treatment target (R10). Variability between centers existed but was moderate. The only factor determining the performance of a DAS28 in the last visit was the patient's center of origin.
The Canary Island centers studied achieved high levels of remission and low activity in their patients. The performance of composite indices and follow-up frequency recommended by the t2t are met, although there is room for improvement.
分析对达标治疗（t2t）临床实践指南的依从性。
对加那利群岛5家医院连续就诊的类风湿关节炎（RA）患者进行横断面观察性研究。患者填写活动量表、健康评估问卷（HAQ），并回答医生是否解释过治疗目标的问题。风湿科医生还收集了：过去一年的就诊次数、活动指数和HAQ的使用情况、本次就诊的疾病活动度评分28（DAS28）以及下次就诊日期。分析了基于t2t推荐（R）1、3、5 - 7和10的指标依从率。
共招募343例患者，77%为女性，平均年龄57岁，RA病程10年。去年的就诊次数中位数为3次，上次就诊与本次就诊的平均间隔时间为5.6个月。共有93%的患者接受了改善病情抗风湿药（DMARDs）治疗，44%的患者根据DAS达到缓解（R1）。在上次就诊时，85%的患者有记录的关节计数，19%的患者有HAQ，41%的患者有患者视觉模拟评分（VAS），35%的患者有DAS28（R6）。下次就诊的平均预约时间为4.3个月（R5）。在DAS28>3.2的患者中，64%的患者预约了1至3个月后的就诊（R5）。共有96%的患者表示他们已被告知治疗目标（R10）。各中心之间存在差异，但程度适中。上次就诊时进行DAS28检测的唯一决定因素是患者的来源中心。
所研究的加那利群岛各中心的患者达到了较高的缓解水平和低疾病活动度。虽然仍有改进空间，但达到了t2t推荐的综合指标表现和随访频率。
