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Implementation of an assessment checklist for patients with spondyloarthritis in daily practice

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14

  1. Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Madrid, and Escuela Internacional de Doctorado de la Universidad Rey Juan Carlos, Madrid, Spain. ralmodovar@fhalcorcon.es
  2. Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
  3. Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
  4. Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
  5. Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
  6. Servicio de Reumatología, Hospital Universitario de Móstoles, Madrid, Spain.
  7. Servicio de Reumatología, Hospital Universitario Infanta Leonor, Madrid, Spain.
  8. Servicio de Reumatología, Hospital Universitario Infanta Leonor, Madrid, Spain.
  9. Servicio de Reumatología, Hospital Universitario Infanta Leonor, Madrid, Spain.
  10. Servicio de Reumatología, Hospital Universitario de Torrejón, Madrid, Spain.
  11. Servicio de Reumatología, Hospital del Tajo, Madrid, Spain.
  12. Servicio de Reumatología, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.
  13. Instituto de Salud Musculoesquelética, Madrid, Spain.
  14. Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

CER12068 Submission on line
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
To analyse the feasibility and changes in the collection of clinical measures after the implementation in daily practice of a checklist designed for an optimal evaluation and monitoring of patients with spondyloarthritis (SpA).
METHODS:
An observational prospective study was performed. The feasibility of the assessment checklist (paper/on-line format) for patients with SpA was tested (time to complete the checklist, simplicity, amenity clarity, usefulness). Through a medical files review, changes in the number of the checklist variables collected were analysed previous to the implementation of the checklist and 6 months later. A descriptive and bivariate analysis was performed.
RESULTS:
A total 6 hospitals and 11 rheumatologists participated. The median time to checklist completion was 15 (12-20) minutes, and the mean scores for the rest of variables of the feasibility test were in general positives. A total of 83 and 68 medical files pre-implementation and post-implementation were reviewed respectively. We observed a significant increase in the collection of many of the checklist variables after the implementation. The record of BASDAI increased from 46.2% to 73.1% (p=0.001), physical activity from 48.2% to 88.2% (p<0.0001), physician global (VAS) from 28.0% to 73.5% (p<0.0001), patient global (VAS) from 48.8% to 85.3% (p<0.0001), morning stiffness from 62.8% to 84.8% (p=0.003), ASDAS from 12.2% to 32.8% (p=0.002), BASFI from 43.7% to 65.7% (p=0.008), or DAS28 from 24.7% to 46.3% (p=0.006). These changes were observed irrespectively of SpA classification.
CONCLUSIONS:
The implementation of an assessment checklist in daily practice is feasible and improves the assessment of SpA patients.

PMID: 31287409 [PubMed]

Received: 11/01/2019 - Accepted : 15/04/2019 - In Press: 11/06/2019