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EULAR/eumusc.net standards of care for rheumatoid arthritis : cross-sectional analyses of importance, level of implementation and care gaps experienced by patients and rheumatologists across 35 European countries

Meisters, Rachelle ; Putrik, Polina ; Ramiro, Sofia ; Hifinger, Monika ; Keszei, Andras P. ; Van Eijk-Hustings, Yvonne ; Woolf, Anthony D. ; Smolen, Josef S. ; Stamm, Tanja A. and Stoffer-Marx, Michaela , et al. (2020) In Annals of the Rheumatic Diseases 79(11). p.1423-1431
Abstract

Objective As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. Methods Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care... (More)

Objective As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. Methods Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0-100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation<6) and strong barriers (≥6) were further analysed in multilevel logistic regression models. Results Overall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients. Conclusions Many problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arthritis, health care, health services research, outcome and process assessment, rheumatoid
in
Annals of the Rheumatic Diseases
volume
79
issue
11
pages
9 pages
publisher
BMJ Publishing Group
external identifiers
  • pmid:32873554
  • scopus:85092944463
ISSN
0003-4967
DOI
10.1136/annrheumdis-2020-217520
language
English
LU publication?
yes
id
f93ad657-437e-4776-8b37-6b2ba29f169d
date added to LUP
2020-11-06 07:44:27
date last changed
2024-09-05 07:42:32
@article{f93ad657-437e-4776-8b37-6b2ba29f169d,
  abstract     = {{<p>Objective As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. Methods Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0-100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation&lt;6) and strong barriers (≥6) were further analysed in multilevel logistic regression models. Results Overall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients. Conclusions Many problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs. </p>}},
  author       = {{Meisters, Rachelle and Putrik, Polina and Ramiro, Sofia and Hifinger, Monika and Keszei, Andras P. and Van Eijk-Hustings, Yvonne and Woolf, Anthony D. and Smolen, Josef S. and Stamm, Tanja A. and Stoffer-Marx, Michaela and Uhlig, Till and Moe, Rikke Helene and De Wit, Maarten and Tafaj, Argjend and Mukuchyan, Vahan and Studenic, Paul and Verschueren, Patrick and Shumnalieva, Russka and Charalambous, Paraskevi and Vencovský, Jirí and Varvouni, Melpomeni and Kull, Mart and Puolakka, Kari and Gossec, Laure and Gobejishvili, Nino and Detert, Jacqueline and Sidiropoulos, Prodromos and Péntek, Márta and Kane, David and Scirè, Carlo Alberto and Arad, Uri and Andersone, Daina and Van De Laar, Mart and Van Der Helm-Van Mil, Annette and Głuszko, Piotr and Cunha-Miranda, Luís and Berghea, Florian and Damjanov, Nemanja S. and Tomšič, Matija and Carmona, Loreto and Turesson, Carl and Ciurea, Adrian and Shukurova, Surayo and Inanc, Nevsun and Verstappen, Suzanne M.M. and Boonen, Annelies}},
  issn         = {{0003-4967}},
  keywords     = {{arthritis; health care; health services research; outcome and process assessment; rheumatoid}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1423--1431}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Annals of the Rheumatic Diseases}},
  title        = {{EULAR/eumusc.net standards of care for rheumatoid arthritis : cross-sectional analyses of importance, level of implementation and care gaps experienced by patients and rheumatologists across 35 European countries}},
  url          = {{http://dx.doi.org/10.1136/annrheumdis-2020-217520}},
  doi          = {{10.1136/annrheumdis-2020-217520}},
  volume       = {{79}},
  year         = {{2020}},
}