An original investigation published by Seyferth et al in JAMA Network Open identified six quality care measures for patients with rheumatoid arthritis and determined their success at achieving these measures in patients who were followed for 1 year postdiagnosis. The researchers also sought to identify factors and causes tied to achieving or failing to meet these measures. The studied measures were: referral to a rheumatologist; hepatitis B screening prior to disease-modifying antirheumatic drug (DMARD) initiation; baseline hand radiographs within 1 year of the initial visit; annual physical examination; annual laboratory testing; and physical therapy, occupational therapy, or hand surgery referral. About 69% of patients met at least one quality care marker, while about 31% did not meet any. Being referred to a rheumatologist and receiving DMARDs seemed to have downstream effects on meeting other markers, though only about 44% of patients in the study received a rheumatologist referral and only 33% received a DMARD prescription. In addition, male patients, those on Medicare, and those with comorbidities were less likely to meet their quality care markers. The study authors wrote that their findings “…support prior research that has found variable quality of rheumatoid arthritis care and indicates specific patient populations that can be targeted for improvement. In addition, this study supports the Arthritis Foundation guidelines and the importance of early diagnosis and care for patients with rheumatoid arthritis.”
May 25, 2023