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High Adherence to System‐Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years
Author(s) -
Barber Claire E. H.,
Schieir Orit,
Lacaille Diane,
Marshall Deborah A.,
Barnabe Cheryl,
Hazlewood Glen,
Thorne J. Carter,
Ahluwalia Vandana,
Bartlett Susan J.,
Boire Gilles,
Haraoui Boulos,
Hitchon Carol,
Keystone Edward,
Tin Diane,
Pope Janet E.,
Denning Lisa,
Bykerk Vivian P.
Publication year - 2018
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23439
Subject(s) - medicine , rheumatoid arthritis , cohort , rheumatology , rheumatism , percentile , arthritis , physical therapy , surgery , mathematics , statistics
Objective To assess adherence to 3 system‐level performance measures in a national early rheumatoid arthritis ( RA ) cohort. Methods Patients enrolled in the Canadian Early Arthritis Cohort (2007–2015) who met 1987 or 2010 American College of Rheumatology/European League Against Rheumatism criteria with <1 year of symptom duration and ≥1 year of followup after enrollment were included. Performance measures assessed were the percentage of RA patients seen in yearly followup, and the number of gaps between visits of >12 or >14 months, the percentage of RA patients treated with a disease‐modifying antirheumatic drug ( DMARD ), and days from RA diagnosis to initiation of a DMARD . Results are shown stratified by enrollment year to assess for temporal changes in performance. Results A total of 1,763 early RA patients were included (mean age 54 years, 73% female, and 82% white). At enrollment, mean ± SD disease duration was 6 ± 3 months, and Disease Activity Score in 28 joints was 5.1 ± 1.5. Over 8 years, the proportion of patients seen in annual followup declined from 100% to 91%. Over followup, 42% of patients had 0 gaps in care of >12 months, and 64% had 0 gaps >14 months. The percentage of DMARD ‐treated early RA patients was and remained high (95–87%), and the percentage receiving DMARD s within 14 days of diagnosis was 75%. Median time‐to‐ DMARD therapy was 1 day, indicating DMARD s were initiated at diagnosis (90th percentile 93 days). Conclusion There was evidence of high adherence to system‐level performance measures in this early RA cohort following a protocol. Small declines in performance were noted with increasing length of patient followup. Our findings are useful for performance measure benchmarking.