Better Clinical Results in Rheumatoid Arthritis Patients Treated Under a Multidisciplinary Care Model When Compared with a National Rheumatoid Arthritis Registry

Pedro Santos-Moreno; Gabriel-Santiago Rodríguez-Vargas; Susan Martínez; Linda Ibatá; Laura Villarreal-Peralta; Anggie Aza-Cañon; Manuel Rivero; Pedro Rodriguez; Adriana Rojas-Villarraga

doi:10.2147/OARRR.S385423

Better Clinical Results in Rheumatoid Arthritis Patients Treated Under a Multidisciplinary Care Model When Compared with a National Rheumatoid Arthritis Registry

Open Access Rheumatol. 2022 Nov 18:14:269-280. doi: 10.2147/OARRR.S385423. eCollection 2022.

Authors

Pedro Santos-Moreno¹, Gabriel-Santiago Rodríguez-Vargas¹, Susan Martínez², Linda Ibatá², Laura Villarreal-Peralta¹, Anggie Aza-Cañon¹, Manuel Rivero¹, Pedro Rodriguez¹, Adriana Rojas-Villarraga³

Affiliations

¹ Rheumatology Department, Biomab IPS, Bogotá, Colombia.
² Epidemiology Department, Epithink Health Consulting, Bogotá, Colombia.
³ Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia.

Abstract

Purpose: To describe clinical characteristics and effectiveness of health care in patients with rheumatoid arthritis (RA) as part of a multidisciplinary care model (MCM) in a specialized rheumatology center, compared with the results of a national registry of RA (NARRA) as evidence of real-world management.

Patients and methods: We conducted a real-world study (July 1, 2018 to June 30, 2019) based on an analysis of electronic health records of a cohort of RA patients managed with the "Treat-to-Target" strategy in a specialized rheumatology center in Colombia with an MCM, compared with the NARRA that includes different models of usual care.

Results: We have analyzed 7053 subjects with RA treated at a specialized rheumatology center and 81,492 patients from the NARRA. Cohorts were similar in their baseline characteristics, with women in predominance and diagnosis age close to 50 years. At the time of diagnosis, a higher proportion of clinical diagnostic test use and rheumatology consultation access was observed in the specialized rheumatology center than in the national registry (4-6 per year versus three or less). In addition, higher proportions of patients in remission and low disease activity were reported for the specialized rheumatology center, with a >40% amount of data lost in the national registry. Pharmacological management was similar regarding the analgesic use. In the specialized center, Certolizumab was more frequently used than in the NARRA registry; also, there were significant differences in methotrexate, leflunomide, and sulfasalazine use, being higher in the specialized rheumatology center.

Conclusion: The MCM of a specialized center in RA can guarantee comprehensive care, with better access to all the services required to manage the disease. It ensures specialist management and evidence-based care that facilitates the achievement of therapeutic objectives. In addition, better patient records and follow-ups are available to evaluate health outcomes.

Keywords: multidisciplinary healthcare; real-world data; rheumatoid arthritis; therapeutics.