Klemm P, Hudowenz O, Asendorf T, Müller-Ladner U, Lange U, Tarner I H
Abt. für Rheumatologie, Klinische Immunologie, Osteologie und Physikalische Medizin, Kerckhoff-Klinik GmbH Bad Nauheim, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland.
Institut für Medizinische Statistik, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Z Rheumatol. 2019 Mar;78(2):136-142. doi: 10.1007/s00393-019-0593-z.
Multimodal rheumatologic complex treatment (MRCT, operation and procedures classification system, OPS code 8‑983) is a specific concept of acute inpatient care (DRG I97Z) for treatment of patients with rheumatic diseases, degenerative diseases and/or chronic pain syndromes suffering from exacerbated pain and functional impairment.
A monocentric retrospective analysis of the effects of MRCT on pain and functional status in patients with rheumatoid arthritis (RA) was conducted.
A total of 103 treatment episodes in 75 patients with proven RA who received MRCT between 2014 and 2017 were included in the analysis. The changes in pain intensity were evaluated using a numerical rating scale (NRS), the functional limitations as assessed by the Hanover function questionnaire (FFbH) and the health assessment questionnaire (HAQ) and the disease activity (disease activity score of 28 joints, DAS28) before and after MRCT episodes. In addition, the patient characteristics and the course of the disease were documented and a univariate analysis of the influence of these factors on the parameters activity and function was performed.
In patients with RA, the MRCT resulted in a significant amelioration of pain (p < 0.0001), a significant improvement of functional capacity (FFbH p = 0.0013, HAQ p = 0.1396) and a significant reduction of disease activity (DAS28 p < 0.0001). Different aspects of the disease and its previous course (e. g. disease duration, type and number of previous anti-rheumatic drugs, current medication) did not have a significant effect on the response.
This retrospective monocentric analysis proved the efficacy of MRCT with respect to the inpatient treatment period in a large cohort of RA patients. This treatment concept not only improved pain and function (FFbH) but also significantly reduced the disease activity.
多模式风湿综合治疗（MRCT，手术及操作分类系统，OPS编码8-983）是针对患有风湿性疾病、退行性疾病和/或慢性疼痛综合征且疼痛加剧和功能受损的患者进行急性住院治疗（诊断相关分组I97Z）的一个特定概念。
对多模式风湿综合治疗（MRCT）对类风湿关节炎（RA）患者疼痛和功能状态的影响进行单中心回顾性分析。
分析纳入了2014年至2017年间接受MRCT治疗的75例确诊RA患者的103个治疗疗程。使用数字评分量表（NRS）评估疼痛强度变化，采用汉诺威功能问卷（FFbH）、健康评估问卷（HAQ）评估功能受限情况，并在MRCT疗程前后评估疾病活动度（28个关节疾病活动评分，DAS28）。此外，记录患者特征和疾病进程，并对这些因素对活动度和功能参数的影响进行单因素分析。
在RA患者中，MRCT使疼痛显著改善（p<0.0001），功能能力显著提高（FFbH p=0.0013，HAQ p=0.1396），疾病活动度显著降低（DAS28 p<0.0001）。疾病的不同方面及其既往病程（如病程、既往抗风湿药物的类型和数量、当前用药）对反应无显著影响。
这项回顾性单中心分析证明了多模式风湿综合治疗（MRCT）在大量RA患者住院治疗期间的疗效。这种治疗理念不仅改善了疼痛和功能（FFbH），还显著降低了疾病活动度。
