Hoeper Juliana Rachel, Schuch Florian, Steffens-Korbanka Patricia, Gauler Georg, Welcker Martin, Wendler Jörg, von Hinüber Ulrich, Meyer Sara Eileen, Schwarting Andreas, Zeidler Jan, Witte Torsten, Meyer-Olson Dirk, Hoeper Kirsten
Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover, Deutschland.
Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Deutschland.
Z Rheumatol. 2024 Jun;83(5):407-415. doi: 10.1007/s00393-023-01403-9. Epub 2023 Aug 30.
At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care.
The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease.
A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail.
In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003).
A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.
类风湿关节炎（RA）患者中至少80%存在至少一种合并症。除心血管合并症外，心理合并症也很常见。患者中抑郁和焦虑的患病率高于一般人群。筛查合并症至关重要。门诊专科护理资源短缺，几乎没有资源用于此。实施团队式护理有可能提高护理标准，同时应对护理资源短缺问题。
本研究旨在探讨护理对血清学阳性且疾病活动的RA患者抑郁和焦虑病程的影响。
一项多中心实用随机对照试验在1年时间内对224例患者进行。基线检查后，又进行了5次随访。在干预组（IG），最初3次随访由合格的风湿病助理进行。详细观察抑郁、焦虑及患者对门诊护理的满意度。
在IG组，焦虑症状在12个月内显著改善（p = 0.036）。IG组焦虑患者比例也显著变化（p < 0.001），而对照组在基线和第12个月之间无变化。抑郁量表评分无显著差异（p = 0.866）。在满意度问卷的信息维度方面，IG组患者在6个月（p = 0.013）和12个月（p = 0.003）后感觉得到了显著更好的信息。
对于血清学阳性且疾病活动的RA患者，团队式护理对抑郁和焦虑病程有积极影响。
