Attending and non-attending patients in a real-life setting of an early arthritis clinic: why do people leave clinics and where do they go?
Clin Exp Rheumatol
; 30(2): 184-90, 2012.
Article
in En
| MEDLINE
| ID: mdl-22325985
ABSTRACT
OBJECTIVES:
Rheumatologist assessment as early as possible is considered essential for patients with inflammatory joint disease. In our Very Early Arthritis Clinic (VEAC), a substantial proportion of initially included and followed patients later stop attendance in the clinic. We questioned attending (AP) and non-attending patients (NAP) regarding current health status and satisfaction with care as well as reasons for discontinuation and current care received by NAP.METHODS:
VEAC patients first seen between 1996 and 2003 were included. Assessment included the RADAI, HAQ, and visual analogue scales for pain, disease activity, fatigue, satisfaction with current health care. Current (DMARD) treatment was recorded.RESULTS:
Among AP, 87% had rheumatoid arthritis (RA) and 13% non-RA. Of NAP, 37% had RA, 23% non-RA and 40% no more rheumatic disease. Satisfaction with health care concerning rheumatic disease was better in AP than NAP. Likewise, most outcome parameters were better in AP. Substantially more RA patients in the AP than NAP group received DMARDs. Apart from the disappearance of arthritis, logistic reasons were given most frequently for discontinuation of attendance. Less than 10% of NAP indicated dissatisfaction with medical care.CONCLUSIONS:
We found advantages in both disease activity measures and satisfaction with health care for patients receiving continuous care in a highly specialised Rheumatology clinic. Furthermore, different DMARD usage in RA in AP and NAP may indicate significant deficits in treatment quality outside specialist care. Logistic issues associated with access to continuous Rheumatology care for early arthritis patients need improvement.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Outpatient Clinics, Hospital
/
Arthritis
/
Arthritis, Rheumatoid
/
Health Behavior
/
Health Knowledge, Attitudes, Practice
/
Patient Compliance
/
Continuity of Patient Care
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Clin Exp Rheumatol
Year:
2012
Document type:
Article
Affiliation country:
Austria