Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres.

Autor:	Dreher M; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Witte T; Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany., Hoeper K; Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.; Center for Rheumatology Lower Saxony, Hannover, Germany., Assmann G; Center of Rheumatology and Clinical Immunology, RUB-University Hospital Minden JWK, Minden, Germany., Proft F; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany., Poddubnyy D; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charite Universitatsmedizin Berlin, Berlin, Germany., Murawski N; Internal Medicine I Oncology, Haematology, Clinical Immunology and Clinical Rheumatology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany., Triantafyllias K; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.; Center for Rheumatology Rhineland-Palatinate, Bad Kreuznach, Germany., Grodd M; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Graf E; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Fichtner UA; Institute of Medical Biometry and Statistics, Section of Healthcare Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Binder H; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany., Zeidler J; Center for Health Economics Research Hannover (CHERH), Leibniz Universitat Hannover, Hannover, Germany., Hoeper JR; Center for Health Economics Research Hannover (CHERH), Leibniz Universitat Hannover, Hannover, Germany., Callhoff J; Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany.; Institute for Social Medicine, Epidemiology and Health Economics, Charite Universitatsmedizin Berlin, Berlin, Germany., Karberg K; Center for Rheumatology Berlin, Berlin, Germany., Trautwein A; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Tibyampansha D; Department of Pharmacolgy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Wojnowski L; Department of Pharmacolgy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany., Schmidt RE; Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany., Schwarting A; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany schwarting@uni-mainz.de.; Center for Rheumatology Rhineland-Palatinate, Bad Kreuznach, Germany.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2024 Jan 11; Vol. 83 (2), pp. 184-193. Date of Electronic Publication: 2024 Jan 11.
DOI:	10.1136/ard-2023-224205
Abstrakt:	Objectives: Early diagnosis of inflammatory arthritis is critical to prevent joint damage and functional incapacities. However, the discrepancy between recommendations of early diagnosis and reality is remarkable. The Rheuma-VOR study aimed to improve the time to diagnosis of patients with early arthritis by coordinating cooperation between primary care physicians, specialists and patients in Germany. Methods: This prospective non-randomised multicentre study involved 2340 primary care physicians, 72 rheumatologists, 4 university hospitals and 4 rheumatology centres in 4 German Federal States. The two coprimary endpoints (time to diagnosis and screening performance of primary care physicians) were evaluated for early versus late implementation phase. Additionally, time to diagnosis and secondary endpoints (decrease of disease activity, increase in quality of life and overall well-being, improvement of fatigue, depression, functional ability, and work ability, reduction in drug and medical costs and hospitalisation) were compared with a reference cohort of the German Rheumatism Research Centre (DRFZ) reflecting standard care. Results: A total of 7049 patients were enrolled in the coordination centres and 1537 patients were diagnosed with a rheumatic disease and consented to further participation. A follow-up consultation after 1 year was realised in 592 patients. The time to diagnosis endpoint and the secondary endpoints were met. In addition, the calculation of cost-effectiveness shows that Rheuma-VOR has a dominant cost-benefit ratio compared with standard care. Discussion: Rheuma-VOR has shown an improvement in rheumatological care, patient-reported outcome parameters and cost savings by coordinating the cooperation of primary care physicians, rheumatologists and patients, in a nationwide approach. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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