Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial

Fransen, Jaap

doi:10.1136/ard.62.7.624

Cited by 26 publications

(12 citation statements)

References 22 publications

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“…Studies show that systematic monitoring of the RA disease course and changing medication on the basis of the disease activity outcomes leads to lower disease activity in RA patients [1][2][3][4][5][6][7][8][9][10]. In most of these studies, anti-rheumatic therapy is intensified on the basis of a composite disease activity score such as the disease activity score of 28 joints (DAS28) [4,5,7,9,10].…”

Section: Introductionmentioning

confidence: 99%

How to improve DAS28 use in daily clinical practice?--a pilot study of a nurse-led intervention

et al. 2010

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Objectives. To determine whether DAS28 measurements by a specialized nurse, before the rheumatologist visit, in combination with the advice to rheumatologists to reach a DAS28 4 3.2, had beneficial effects on disease activity and medication prescription in patients with RA and to explore possible predictors for variation in medication changes and reasons for non-adherence to the advice to reach a DAS28 4 3.2.Methods. In this pilot study, rheumatologists were randomized to 'usual care' (n = 3) or DAS28 measurement by a nurse prior the rheumatologist visit (n = 4). In the usual care group, the DAS28 was measured but not provided to rheumatologists. Mixed model analyses were used for analysing between-group differences and for the prediction model. Rheumatologists in the intervention group were asked to provide reasons in cases of non-adherence to the advice.Results. After 18 months, DAS28 was reduced by À 0.69 and À 0.66 (P = 0.70) in, respectively, the intervention (144 patients) and the usual care (104 patients) groups. In the intervention group, medication was changed by rheumatologists in 35% of the visits with a DAS28 > 3.2; in the usual care group this was 33% (P = 0.99). Baseline DAS28 (OR 1.6; P40.0001) and HAQ (OR 1.3; P = 0.03) were positively related to a medication change. The most frequently mentioned reason not to change medication was patient refusal (26%).Conclusions. DAS28 measurement by a nurse was as effective as usual care; however, this intervention without protocolized treatment adjustments is not sufficient to lead to a considerable reduction in disease activity compared with trials with protocolized treatment adjustments.

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Section: Introductionmentioning

confidence: 99%

How to improve DAS28 use in daily clinical practice?--a pilot study of a nurse-led intervention

et al. 2010

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“…4 Disease activity is an outcome measure, which is used to evaluate health outcome in the patients with rheumatic diseases. 5 It is difficult to define disease activity of BD because of its fluctuating course, absence of laboratory tests reflecting all clinical findings, and lack of standardized form representing the severity of BD manifestations. 6 Various scales have been used for measuring disease activity in BD.…”

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confidence: 99%

Disease Activity in Turkish Patients with Behçet's Disease: Association with Fatigue, Psychological Status and Quality of Life

Güler¹,

Aslan²,

Garip³

et al. 2017

Turkiye Klinikleri J Med Sci

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“…Zu den ersten Versuchen, systematisch in größerem Umfang kontinuierliche Erhebungen der Krankheitsaktivität durchzuführen, zählt die Initiative aus Zürich [5,16] Hinsichtlich der radiologischen Progression (gemessen mittels des RatingenScores [12]) war zwar das Fortschreiten der Veränderungen numerisch am geringsten in der Gruppe 4 und am größten in der Gruppe 3, die Unterschiede zwischen den Gruppen waren aber nicht signifikant.…”

Section: Zürich/schweizunclassified

“…In den Niederlanden wurde daher eine Studie unter Verwendung des DAS 28 durchgeführt [5], der etwas einfacher als der DAS 44 zu erheben ist. Das Protokoll beinhaltete darüber hinaus keine fixen Vorgaben für etwaige Therapiemodifikationen.…”

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Aktivitätsscore-basierte Therapieadaptation bei chronischer Polyarthritis

et al. 2006

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Disease activity scores for rheumatoid arthritis have been developed and validated in recent years. They allow the longitudinal documentation of the effectiveness of treatment. Application of these scores in routine daily practice could significantly improve the effectiveness of therapy with relatively little effort. This review presents evidence for the benefits of the application disease activity scores in clinical routine.

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Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial

Cited by 26 publications

References 22 publications

How to improve DAS28 use in daily clinical practice?--a pilot study of a nurse-led intervention

How to improve DAS28 use in daily clinical practice?--a pilot study of a nurse-led intervention

Disease Activity in Turkish Patients with Behçet's Disease: Association with Fatigue, Psychological Status and Quality of Life

Aktivitätsscore-basierte Therapieadaptation bei chronischer Polyarthritis

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