Skip to main content

Advertisement

SpringerLink
Log in

Disease activity outcome measures are only available in half of the electronic medical files of patients with axial spondyloarthritis followed in an outpatient clinic: the results of an audit of a tertiary-care rheumatology department

  • Observational Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Current recommendations for management of patients with axial spondyloarthritis (axSpA) include regular collection of validated disease activity outcomes. This study aimed at evaluating the proportion of patients for whom validated outcome measures were available on their electronic medical reports (EMR), and the factors associated with the presence of such information on the EMR. We performed a cross-sectional monocentric observational study, including patients with an axSpA diagnosis who attended an outpatient visit between February, 2018 and February, 2019. Patients (demographics, disease characteristics, treatment) and physician characteristics (age, gender) and the disease activity outcome measures (BASDAI, CRP and ASDAS, and the items allowing to calculate them) were retrieved from the EMR. The proportion of patients in which disease activity outcome measures were available in the EMR was calculated, and the association between the presence of such outcomes and patients and physician’s characteristics was evaluated. 320 EMR of axSpA patients seen in the outpatient clinic were examined. Among them, 131 (41%) and 123 (38.4%) had a BASDAI + CRP and an ASDAS reported, respectively, but at least one was available in 178 (55.6%) of the EMR. The most frequently reported disease activity items were duration of morning stiffness (n = 230, 72%) and CRP (n = 224, 70%). Only previous participation on a systematic holistic review was independently associated with a reported disease activity outcome. Thus, implementation of recommendations with regard to regularly collecting disease activity outcome measures is not optimal. The participation in educational programs including self-assessment educational programs might be a key to improve such implementation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Data sharing statement

The data sets generated and/or analyzed during the current study are not publicly available due to consent restrictions. Programming codes used for statistical analysis during the current study are available from the corresponding author upon reasonable request.

References

  1. van der Heijde D, Ramiro S, Landewé R et al (2017) 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 76:978–991. https://doi.org/10.1136/annrheumdis-2016-210770

    Article  PubMed  Google Scholar 

  2. Smolen JS, Braun J, Dougados M et al (2014) Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis 73:6–16. https://doi.org/10.1136/annrheumdis-2013-203419

    Article  PubMed  Google Scholar 

  3. Dougados M (2020) Treat to target in axial spondyloarthritis: from its concept to its implementation. J Autoimmun 110:102398. https://doi.org/10.1016/j.jaut.2019.102398

    Article  PubMed  Google Scholar 

  4. Ramiro S, van der Heijde D, van Tubergen A et al (2014) Higher disease activity leads to more structural damage in the spine in ankylosing spondylitis: 12-year longitudinal data from the OASIS cohort. Ann Rheum Dis 73:1455–1461. https://doi.org/10.1136/annrheumdis-2014-205178

    Article  PubMed  Google Scholar 

  5. Molnar C, Scherer A, Baraliakos X et al (2018) TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort. Ann Rheum Dis 77:63–69. https://doi.org/10.1136/annrheumdis-2017-211544

    Article  CAS  PubMed  Google Scholar 

  6. Machado PM, Deodhar A (2019) Treat-to-target in axial spondyloarthritis: gold standard or fools’ gold? Curr Opin Rheumatol 31:344–348. https://doi.org/10.1097/BOR.0000000000000625

    Article  PubMed  Google Scholar 

  7. Poddubnyy D, Protopopov M, Haibel H et al (2016) High disease activity according to the Ankylosing Spondylitis Disease Activity Score is associated with accelerated radiographic spinal progression in patients with early axial spondyloarthritis: results from the GErman SPondyloarthritis Inception Cohort. Ann Rheum Dis 75:2114–2118. https://doi.org/10.1136/annrheumdis-2016-209209

    Article  PubMed  Google Scholar 

  8. Schoels MM, Braun J, Dougados M et al (2014) Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis. Ann Rheum Dis 73:238–242. https://doi.org/10.1136/annrheumdis-2013-203860

    Article  CAS  PubMed  Google Scholar 

  9. Nikiphorou E, Baraliakos X (2019) Treat to target in axial spondyloarthritis. Rheum Dis Clin N Am 45:519–535. https://doi.org/10.1016/j.rdc.2019.07.003

    Article  Google Scholar 

  10. Che H, Etcheto A, Dernis E et al (2015) Evaluation of collected outcome measures in axial spondyloarthritis in daily-care rheumatology settings: the experience of the RHEVER network. Clin Exp Rheumatol 33:851–857

    CAS  PubMed  Google Scholar 

  11. Molto A, Gossec L, Poiraudeau S et al (2020) Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: the results of the COMEDSPA prospective, controlled, one year randomized trial. Semin Arthritis Rheum 50:701–708. https://doi.org/10.1016/j.semarthrit.2020.05.012

    Article  CAS  PubMed  Google Scholar 

  12. Kiltz U, Landewé RBM, van der Heijde D et al (2020) Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis. Ann Rheum Dis 79:193–201. https://doi.org/10.1136/annrheumdis-2019-216034

    Article  PubMed  Google Scholar 

  13. Baillet A, Romand X, Pflimlin A et al (2020) Data to be collected for an optimal management of axial spondyloarthritis in daily practice: proposal from evidence-based and consensual approaches. Jt Bone Spine 87:405–411. https://doi.org/10.1016/j.jbspin.2020.04.019

    Article  Google Scholar 

  14. Gutermann L, Dumas S, Lopez-Medina C et al (2020) Impact of a pharmacist-led programme on biologics knowledge and adherence in patients with spondyloarthritis. Clin Exp Rheumatol

Download references

Funding

N/A.

Author information

Authors and Affiliations

  1. Rheumatology Department, Cochin Hospital, APHP, 27 rue du Faubourg Saint Jacques, 75014, Paris, France

    Elodie Portier, Maxime Dougados & Anna Moltó

  2. INSERM U-1153, CRESS, University of Paris, Paris, France

    Maxime Dougados & Anna Moltó

Authors
  1. Elodie Portier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maxime Dougados
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Moltó
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

EP, AM: conception, design, analysis and interpretation of data. EP: drafting the article. All authors critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Elodie Portier.

Ethics declarations

Conflict of interest

The authors declare no competing interests regarding this work.

Ethical approval information

N/A.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Portier, E., Dougados, M. & Moltó, A. Disease activity outcome measures are only available in half of the electronic medical files of patients with axial spondyloarthritis followed in an outpatient clinic: the results of an audit of a tertiary-care rheumatology department. Rheumatol Int 42, 825–829 (2022). https://doi.org/10.1007/s00296-021-05055-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-021-05055-3

Keywords

Search

Navigation