Efficacy and Outcome of Rapid Access Rheumatology Consultation: An Office-based Pilot Cohort Study.

Autor:	Puchner R; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna. rudolf.puchner@cc-net.at., Janetschko R; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Kaiser W; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Linkesch M; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Steininger M; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Tremetsberger R; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Alkin A; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna., Machold K; From the Centre of Excellence in Medicine, Linz; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.R. Puchner, MD, MSc, MBA, Private Practice, Wels; R. Janetschko, MD, Private Practice, Linz; W. Kaiser, MD, Private Practice, Linz; M. Linkesch, MD, Private Practice, Linz; M. Steininger, MD, Private Practice, Steyr; R. Tremetsberger, MD, Private Practice, Weyer; A. Alkin, MSc, Centre of Excellence in Medicine; K. Machold, MD, PhD, Professor of Rheumatology, Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2016 Jun; Vol. 43 (6), pp. 1130-5. Date of Electronic Publication: 2016 Apr 01.
DOI:	10.3899/jrheum.151210
Abstrakt:	Objective: Waiting times for first appointments are a major obstacle to timely rheumatology care. To improve access, a cooperative of office-based rheumatologists established an immediate access network, offering brief initial assessments for patients with musculoskeletal problems. Methods: Patients were assessed at presentation and followed up after 6 months. Data were analyzed regarding demographics, diagnostic accuracy, clinical variables such as pain levels, and care. Results: There were 335 patients assessed in the 6 cooperating practices during dedicated office hours. There were 124 patients (38%) who had a symptom duration of < 3 months. For patients with rheumatoid arthritis (RA), this proportion was 43% (70% for self-referred patients with RA). In the 325 patients available for reassessment after 6 months, initially suspected diagnoses were confirmed in 88%. Confirmation rates were 93% for RA (59 patients) and 84% for spondyloarthritis (SpA; 46 patients). At the followup examination, the visual analog scale for pain in patients with RA had significantly decreased from a median (interquartile range) of 70 (57.75-80) to 27.5 (20-42). For patients with SpA, the decrease was from 65 (50-79) to 30 (20-40). Conclusion: The Rapid Access Clinic resulted in a substantial improvement of access to rheumatology assessment. More than one-third of the patients presented < 3 months after symptom onset. Suspected diagnoses of inflammatory rheumatic diseases were confirmed in almost 90%. This initiative demonstrates the feasibility of a rapid access service and indicates high diagnostic accuracy in such a setting. In particular, with respect to early access, it compares favorably with similar hospital-based approaches.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu