The spectrum of early rheumatoid arthritis practice across the globe: results from a multinational cross sectional survey.
Clin Exp Rheumatol
; 35(3): 477-483, 2017.
Article
en En
| MEDLINE
| ID: mdl-28134086
ABSTRACT
OBJECTIVES:
To explore patterns of real-world early RA (ERA) care across countries.METHODS:
An online survey was disseminated to practising rheumatologists across Europe and the US, also made accessible on social media between April and May 2015. Survey questions (n=38) assessed the structure and setting of ERA clinics, times to diagnosis and treatment, patient monitoring, guideline use and data recording.RESULTS:
A total of 212 rheumatologists from 39 countries (76% European) completed the survey. 62% had an ERA clinic based at a university hospital. Patient referral to rheumatology was mainly (78%) via primary care; 44% had an agreed ERA local referral pathway, 15% a national pathway. Only 16% had dedicated ERA clinics, the majority being practitioners in Northern Europe with access to a local or national referral pathway. Data for research were collected by 42%. Treatment guidelines were followed by the majority, especially rheumatologists practising in Europe. Variations existed in the use of initial DMARDs with treatment decisions reported to be influenced by international/national guidelines in 71%/61%. No significant relationship between country gross national income and the availability of ERA clinics was seen.CONCLUSIONS:
This study provides comparative benchmark information regarding the global provision of ERA care. Substantial variations exist in referral and early assessment pathways with guidelines having a most apparent impact in Northern Europe. Provision of an ERA service does not appear to be constrained by cost, with conceptual factors, e.g. clinician engagement, perhaps playing a role. These initial insights could potentially help harmonise ERA management across countries.
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Bases de datos:
MEDLINE
Métodos Terapéuticos y Terapias MTCI:
Plantas_medicinales
Asunto principal:
Artritis Reumatoide
/
Pautas de la Práctica en Medicina
/
Antirreumáticos
/
Prestación Integrada de Atención de Salud
/
Disparidades en Atención de Salud
/
Reumatólogos
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
País/Región como asunto:
America do norte
/
Europa
Idioma:
En
Revista:
Clin Exp Rheumatol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Finlandia