Resources and strategies for the optimal care of patients with axial spondyloarthritis: The CREA project.

Axial spondyloarthritis Clinical practice Delphi methodology Espondiloartritis axial Estrategias asistenciales Follow-up Management strategies Metodología Delphi Práctica clínica Seguimiento

Journal

Reumatologia clinica
ISSN: 2173-5743
Titre abrégé: Reumatol Clin (Engl Ed)
Pays: Spain
ID NLM: 101717526

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 03 11 2021
accepted: 03 02 2022
pubmed: 7 9 2022
medline: 8 2 2023
entrez: 6 9 2022
Statut: ppublish

Résumé

Axial spondyloarthritis (axSpA) are musculoskeletal diseases with different manifestations. In clinical practice, variability, and limitations in the collection of the outcomes required for follow-up have been observed. The objective of the CREA project was to agree on improvement strategies for the initial assessment and follow-up of patients with axSpA in Spain. A survey with 33 questions was conducted by a representative sample of rheumatologists on clinical practice, resources, and present limitations in the follow-up of patients with axSpA. The results of the survey were discussed in 10 regional meetings, and 105 strategies were proposed and evaluated through a Delphi consensus in which 85 experts participated. The lack of time for clinical visits, the lack of nurses and/or support staff and the delay in performing the imaging tests were the most prominent limitations in the follow-up of patients with axSpA. One hundred and five strategies were proposed related to the evaluation of disease activity, physical function, quality of life and disease impact, to the evaluation of comorbidities and extra-articular manifestations, laboratory tests; imaging tests, physical examination and metrology. Of the total, 85 were considered highly advisable. No regional differences were found. The proposals agreed upon as highly advisable in the present study are applicable to the entire national territory, allow tighter and more homogeneous monitoring of the patients with axSpA, facilitate more comprehensive management of the disease, and respond to the unmet needs detected in the initial survey.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Axial spondyloarthritis (axSpA) are musculoskeletal diseases with different manifestations. In clinical practice, variability, and limitations in the collection of the outcomes required for follow-up have been observed. The objective of the CREA project was to agree on improvement strategies for the initial assessment and follow-up of patients with axSpA in Spain.
MATERIALS AND METHODS METHODS
A survey with 33 questions was conducted by a representative sample of rheumatologists on clinical practice, resources, and present limitations in the follow-up of patients with axSpA. The results of the survey were discussed in 10 regional meetings, and 105 strategies were proposed and evaluated through a Delphi consensus in which 85 experts participated.
RESULTS RESULTS
The lack of time for clinical visits, the lack of nurses and/or support staff and the delay in performing the imaging tests were the most prominent limitations in the follow-up of patients with axSpA. One hundred and five strategies were proposed related to the evaluation of disease activity, physical function, quality of life and disease impact, to the evaluation of comorbidities and extra-articular manifestations, laboratory tests; imaging tests, physical examination and metrology. Of the total, 85 were considered highly advisable. No regional differences were found.
CONCLUSIONS CONCLUSIONS
The proposals agreed upon as highly advisable in the present study are applicable to the entire national territory, allow tighter and more homogeneous monitoring of the patients with axSpA, facilitate more comprehensive management of the disease, and respond to the unmet needs detected in the initial survey.

Identifiants

pubmed: 36064886
pii: S2173-5743(22)00116-2
doi: 10.1016/j.reumae.2022.02.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

82-89

Informations de copyright

Copyright © 2022 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Auteurs

Cristina Fernández-Carballido (C)

Hospital Universitario San Juan de Alicante, Alicante, Spain. Electronic address: soficarballido@hotmail.com.

Raquel Almodóvar (R)

Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Juan D Cañete (JD)

Hospital Clínic e IDIBAPS, Barcelona, Spain.

Eduardo Collantes (E)

Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain.

Eugenio de Miguel (E)

Hospital Universitario La Paz, Madrid, Spain.

Jordi Gratacós (J)

Hospital Universitario Parc Taulí, Sabadell, Spain; Grupo investigación A8G2 del I3PT, Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.

Xavier Juanola (X)

Hospital Universitario de Bellvitge, Barcelona, Spain.

José A Pinto (JA)

Complejo Hospitalario Universitario de A Coruña, INIBIC, A Coruña, Spain.

Rubén Queiro (R)

Hospital Universitario Central de Asturias, Oviedo, Spain.

Pedro Zarco (P)

Hospital Universitario Fundación Alcorcón, Madrid, Spain.

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Classifications MeSH