Santos-Moreno Pedro, Castillo Paola, Villareal Laura, Pineda Carlos, Sandoval Hugo, Valencia Omaira
Scientific Direction, Biomab Center for Rheumatoid Arthritis, Bogotá, D.C., Colombia.
Research Department, Biomab Center for Rheumatoid Arthritis, Bogotá, D.C., Colombia.
Open Access Rheumatol. 2020 Nov 6;12:249-256. doi: 10.2147/OARRR.S270700. eCollection 2020.
Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases.
We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach.
We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis.
We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p<0.005), including the evaluation of rheumatoid factor, Anti-citrullinated antibodies Disease Activity Score, Health Assessment Questionnaire, number of visits to the rheumatologist, and clinical outcomes measured by the level of disease activity. In addition, when comparing the Center's clinical outcomes - from baseline to the last follow-up, we found an improvement in the level of disease activity, with patients classified in remission increasing from 20.8% to 58.5% (p<0.005), and a reduction in those with high disease activity from 18% to 4.7% (p<0.005).
Real-world evidence showed that patients with rheumatoid arthritis who underwent follow-up under an innovative disease-management model improved their clinical outcomes compared with those patients in a conventional assessment program. These results could suggest a way of improving health policies for patients with rheumatoid arthritis.
护理模式会影响风湿性和肌肉骨骼疾病患者的临床结局。
我们旨在比较类风湿关节炎疾病管理项目的创新模式与传统评估方法相比，如何改善患者的临床结局。
我们对一组5078例被诊断为类风湿关节炎的患者的临床记录中的真实世界数据进行了回顾性分析，这些患者在类风湿关节炎卓越中心接受随访，并与哥伦比亚类风湿关节炎国家登记处报告的临床结局进行比较。
我们发现专业中心项目与哥伦比亚国家登记处报告的常规护理之间在诊断和随访方面存在显著差异（p<0.005），包括类风湿因子评估、抗瓜氨酸化抗体疾病活动评分、健康评估问卷、看风湿病专家的次数以及通过疾病活动水平衡量的临床结局。此外，比较中心从基线到最后一次随访的临床结局时，我们发现疾病活动水平有所改善，病情缓解的患者比例从20.8%增至58.5%（p<0.005），高疾病活动度患者比例从18%降至4.7%（p<0.005）。
真实世界证据表明，与接受传统评估项目的患者相比，在创新疾病管理模式下接受随访的类风湿关节炎患者临床结局得到改善。这些结果可能为改善类风湿关节炎患者的卫生政策提供一种途径。
