Quality-of-care standards for early arthritis clinics

Abstract

The diagnosis and treatment of early arthritis is associated with improved patient outcomes. One way to achieve this is by organising early arthritis clinics (EACs). The objective of this project was to develop standards of quality for EACs. The standards were developed using the two-round Delphi method. The questionnaire, developed using the best-available scientific evidence, includes potentially relevant items describing the dimensions of quality of care in the EAC. The questionnaire was completed by 26 experts (physicians responsible for the EACs in Spain and chiefs of the rheumatology service in Spanish hospitals). Two hundred and forty-four items (standards) describing the quality of the EAC were developed, grouped by the following dimensions: (1) patient referral to the EAC; (2) standards of structure for an EAC; (3) standards of process; (4) relation between primary care physicians and the EAC; (5) diagnosis and assessment of early arthritis; (6) patient treatment and follow-up in the EAC; (7) research and training in an EAC; and (8) quality of care perceived by the patient. An operational definition of early arthritis was also developed based on eight criteria. The standards developed can be used to measure/establish the requirements, resources, and processes that EACs have or should have to carry out their treatment, research, and educational activities. These standards may be useful to health professionals, patient associations, and health authorities.

Distinction and prognosis of early arthritis phenotypes: an analysis in three European cohorts

“…Phenotypes that deviate from this classical 'RA construct' and have less structural progression still show similar levels of disability and impairment of quality of life. RMD Open RMD Open RMD Open criteria, 3 the implementation of early arthritis (EA) clinics 6 and the validation of imaging methods for an earlier detection of synovitis (eg, by ultrasonography or MRI). [7][8][9][10][11] A key contribution was the development of the 2010 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology RA classification criteria, 12 which are more sensitive to capturing the rheumatologist's concept (Gestalt) of early RA than the more specific 1987 ACR classification criteria.…”

Can the adherence to quality of care indicators for early rheumatoid arthritis in clinical practice reduce risk of hospitalisation? Retrospective cohort study based on the Record Linkage of Rheumatic Disease study of the Italian Society for Rheumatology

“…Several scientific efforts focused on the development of a set of HCQIs to be applied at different care levels, using different sources of information. [10][11][12][13][14] When analysed at population level, quality of care is often suboptimal even in efficient healthcare systems, due to delay in referral and diagnosis and low rates of DMARD initiation within the first 6 months from symptom onset. 15 Moreover, the real advantages for healthcare systems of implementing the reference clinical pathway of the early management of RA (eg, adhering to sequence quality of care indicators) are not yet fully established.…”