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Semin Arthritis Rheum. 2014 Aug;44(1):9-13. doi: 10.1016/j.semarthrit.2014.01.003. Epub 2014 Jan 25.

Rheumatoid arthritis quality measures and radiographic progression.

Author information

1
Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham & Women's Hospital, 75 Francis St, PBB-B3, Boston, MA 02115. Electronic address: sdesai5@partners.org.
2
Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham & Women's Hospital, 75 Francis St, PBB-B3, Boston, MA 02115.
3
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
4
Division of Rheumatology, Department of Medicine, University of San Francisco, San Francisco, CA.
5
Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham & Women's Hospital, 75 Francis St, PBB-B3, Boston, MA 02115; Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, MA.

Abstract

OBJECTIVE:

Documentation of quality measures (QMs) in rheumatoid arthritis (RA) is used as a surrogate for measure of quality of care, but the association of this documentation with radiographic outcomes is uncertain. We examined documentation of RA QMs, for disease activity and functional status and the association with radiographic outcomes.

METHODS:

Data were analyzed for 438 RA patients in a longitudinal cohort with complete data on van der Heijde-modified Total Sharp Score (TSS). All rheumatologist (N = 18) notes in the electronic medical record during a 24-month period were reviewed for RA QMs. Any mention of disease activity categorized as low, moderate, or high was considered documentation of the QM for disease activity. Functional status QM documentation included any mention of the impact of RA on function. Change in TSS was quantified with progression defined as ≥1 unit per year. We compared percent of visits with an RA QM documented and mean change in TSS.

RESULTS:

The mean age in the cohort was 56.9 years, disease duration was 10.8 years, baseline DAS28 score was 3.8 (±1.6), 67.7% were seropositive, and 33.9% used a biologic DMARD. Radiographic progression was observed in 28.5%. Disease activity was documented for 29.0% of patient visits and functional status in 74.7%; neither had any significant relationship to mean TSS change (both P > 0.10).

CONCLUSION:

The documentation of RA QMs was infrequent and not associated with radiographic outcomes over 24 months.

KEYWORDS:

Quality measures; Radiographic progression; Rheumatoid arthritis

PMID:
24560878
PMCID:
PMC4111785
DOI:
10.1016/j.semarthrit.2014.01.003
[Indexed for MEDLINE]
Free PMC Article

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