[Reality of care for musculoskeletal diseases at the population level : Results of the PROCLAIR collaborative project. German version].
Versorgungswirklichkeit muskuloskeletaler Erkrankungen auf Bevölkerungsebene : Erkenntnisse aus dem Verbundprojekt PROCLAIR.
Billing data
Disease burden
Inflammatory rheumatic diseases
Treatment
Treatment deficits
Journal
Zeitschrift fur Rheumatologie
ISSN: 1435-1250
Titre abrégé: Z Rheumatol
Pays: Germany
ID NLM: 0414162
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
pubmed:
6
7
2019
medline:
8
10
2019
entrez:
6
7
2019
Statut:
ppublish
Résumé
The objective of the research consortium PROCLAIR was to gain population level knowledge on the treatment of patients with rheumatoid arthritis (RA), axial spondylarthritis (axSpA) and osteoarthritis (OA) in Germany. A main question of the consortium was whether it is possible to identify groups of people who were exposed to a particular risk of undersupply or oversupply of treatment. In addition, the study investigated the validity of claims data for these diseases as a basis for further studies. Cross-sectional surveys were carried out among insurees of the BARMER statutory health insurance fund whose claims data included RA, axSpA and OA diagnoses. The questionnaire data were linked with the claims data of the insured persons if they agreed. In all three diseases risk groups for care deficits could be identified. Persons with RA who are not treated by a specialist have less access to drug treatment. Physical therapy is prescribed for all three diagnoses at a low level, even for people undergoing joint replacement surgery. A connection between depressive symptoms and disease activity or function in axSpA was shown. In addition to the results relevant to care, the PROCLAIR network has also made contributions to critically assess the quality of health insurance data. The combination of billing data with survey data enables a comprehensive description of the treatment of musculoskeletal diseases. Particularly relevant factors are the specialization of the physician, sociodemographic parameters of the patients and the region of residence. In particular, access to treatment cannot be investigated in randomized clinical trials.
Sections du résumé
BACKGROUND
BACKGROUND
The objective of the research consortium PROCLAIR was to gain population level knowledge on the treatment of patients with rheumatoid arthritis (RA), axial spondylarthritis (axSpA) and osteoarthritis (OA) in Germany.
AIMS
OBJECTIVE
A main question of the consortium was whether it is possible to identify groups of people who were exposed to a particular risk of undersupply or oversupply of treatment. In addition, the study investigated the validity of claims data for these diseases as a basis for further studies.
PATIENTS AND METHODS
METHODS
Cross-sectional surveys were carried out among insurees of the BARMER statutory health insurance fund whose claims data included RA, axSpA and OA diagnoses. The questionnaire data were linked with the claims data of the insured persons if they agreed.
RESULTS
RESULTS
In all three diseases risk groups for care deficits could be identified. Persons with RA who are not treated by a specialist have less access to drug treatment. Physical therapy is prescribed for all three diagnoses at a low level, even for people undergoing joint replacement surgery. A connection between depressive symptoms and disease activity or function in axSpA was shown. In addition to the results relevant to care, the PROCLAIR network has also made contributions to critically assess the quality of health insurance data.
DISCUSSION
CONCLUSIONS
The combination of billing data with survey data enables a comprehensive description of the treatment of musculoskeletal diseases. Particularly relevant factors are the specialization of the physician, sociodemographic parameters of the patients and the region of residence. In particular, access to treatment cannot be investigated in randomized clinical trials.
Identifiants
pubmed: 31273459
doi: 10.1007/s00393-019-0664-1
pii: 10.1007/s00393-019-0664-1
doi:
Substances chimiques
Biological Products
0
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
713-721Références
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Oct;51(10):1118-26
pubmed: 18985405
J Rheumatol. 2017 Jun;44(6):766-772
pubmed: 28412709
Pharmacoepidemiol Drug Saf. 2017 Jul;26(7):766-774
pubmed: 28345245
Z Rheumatol. 2017 Feb;76(1):50-57
pubmed: 27379740
Z Rheumatol. 2014 Sep;73(7):607-14
pubmed: 24939007
Rheumatol Int. 2016 Sep;36(9):1255-63
pubmed: 27372078
Z Rheumatol. 2016 Oct;75(8):819-827
pubmed: 27120440
Ann Rheum Dis. 2018 Jul;77(7):1017-1024
pubmed: 29525776
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
Clin Interv Aging. 2018 Nov 14;13:2339-2349
pubmed: 30532524
Health Policy. 2016 Feb;120(2):213-26
pubmed: 26826756
Pharmacoepidemiol Drug Saf. 2012 May;21(5):535-45
pubmed: 22302384
Z Rheumatol. 2018 Mar;77(2):102-112
pubmed: 28324149
Z Rheumatol. 2016 Feb;75(1):90-6
pubmed: 26680365
Rheumatology (Oxford). 2019 Sep 1;58(9):1634-1638
pubmed: 30903141
Z Rheumatol. 2019 Mar 12;:null
pubmed: 30874933
Orthopade. 2018 Dec;47(12):1018-1026
pubmed: 30171290
Z Rheumatol. 2017 Apr;76(3):210-218
pubmed: 27518855
Z Rheumatol. 2019 Mar;78(2):119-126
pubmed: 30478638
J Rheumatol. 2019 Jun;46(6):564-571
pubmed: 30647170