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Stack RJ, Stoffer M, Englbrecht M, Mosor E, Falahee M, Simons G, Smolen J, Schett G, Buckley CD, Kumar K, Hansson M, Hueber A, Stamm T, Raza K. Perceptions of risk and predictive testing held by the first-degree relatives of patients with rheumatoid arthritis in England, Austria and Germany: a qualitative study. BMJ Open 2016; 6:e010555. [PMID: 27357193 PMCID: PMC4932277 DOI: 10.1136/bmjopen-2015-010555] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/18/2016] [Accepted: 04/20/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The family members of patients with rheumatoid arthritis (RA) are at increased risk of developing RA and are potential candidates for predictive testing. This study explored the perceptions of first-degree relatives of people with RA about being at risk of RA and engaging in predictive testing. METHODS 34 first-degree relatives (siblings and offspring) of patients with RA from the UK, Germany and Austria participated in semistructured interviews about their perceptions of RA risk and the prospect of predictive testing. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS First-degree relatives were aware of their susceptibility to RA, but were unsure of the extent of their risk. When considering their future risk, some relatives were concerned about the potential impact that RA would have on their lives. Relatives were concerned that knowing their actual risk would increase their anxiety and would affect decisions about their future. Also, relatives were concerned about the levels of uncertainty associated with predictive testing. Those in favour of knowing their future risk felt that they would need additional support to understand the risk information and cope with the emotional impact of this information. CONCLUSIONS Identifying individuals at risk of RA may allow targeted interventions to reduce the risk and consequence of future disease; however, relatives have concerns about predictive testing and risk information. The development of strategies to quantify and communicate risk needs to take these views into account and incorporate approaches to mitigate concerns and minimise the psychological impact of risk information.
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Affiliation(s)
- Rebecca J Stack
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Division of Psychology, Nottingham Trent University, Nottingham, UK
| | - Michaela Stoffer
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
- University of Applied Sciences for Health Professionals, Upper Austria, Austria
| | - Mathias Englbrecht
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Erika Mosor
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Marie Falahee
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Gwenda Simons
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Josef Smolen
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Georg Schett
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Chris D Buckley
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Division of Psychology, Nottingham Trent University, Nottingham, UK
| | - Kanta Kumar
- Faculty of Medical and Human Sciences, School of Nursing, University of Manchester, Manchester, UK
| | - Mats Hansson
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Axel Hueber
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Tanja Stamm
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Karim Raza
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Department of Rheumatology, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
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Hifinger M, van Eijk Y, Putrik P, Ramiro S, Woolf A, Smolen J, Stoffer M, Uhlig T, Moe R, Saritas M, van de Laar M, Vonkeman H, de Wit M, Janson M, van der Helm-van Mil A, Boonen A. FRI0585 Importance and Level of Implementation of The EULAR/EUMUSC.net Standards of Care for RA in The Netherlands: Similarities and Discordance between Patients and Health Care Professionals. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stamm T, Stoffer M, Smolen J. Response to: 'Evidence for treating rheumatoid arthritis to target: results of a systematic literature search update' by Goswami et al. Ann Rheum Dis 2016; 75:e36. [PMID: 27045105 DOI: 10.1136/annrheumdis-2016-209499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 03/19/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Michaela Stoffer
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Josef Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria Department of Internal Medicine, Centre for Rheumatic Diseases, Hietzing Hospital, Vienna, Austria
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Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Emery P, Kvien TK, Navarro-Compán MV, Oliver S, Schoels M, Scholte-Voshaar M, Stamm T, Stoffer M, Takeuchi T, Aletaha D, Andreu JL, Aringer M, Bergman M, Betteridge N, Bijlsma H, Burkhardt H, Cardiel M, Combe B, Durez P, Fonseca JE, Gibofsky A, Gomez-Reino JJ, Graninger W, Hannonen P, Haraoui B, Kouloumas M, Landewe R, Martin-Mola E, Nash P, Ostergaard M, Östör A, Richards P, Sokka-Isler T, Thorne C, Tzioufas AG, van Vollenhoven R, de Wit M, van der Heijde D. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis 2016; 75:3-15. [PMID: 25969430 PMCID: PMC4717393 DOI: 10.1136/annrheumdis-2015-207524] [Citation(s) in RCA: 941] [Impact Index Per Article: 117.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/10/2015] [Accepted: 04/13/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Reaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this therapeutic goal in routine clinical practice, but these recommendations need to be re-evaluated for appropriateness and practicability in the light of new insights. OBJECTIVE To update the 2010 treat-to-target recommendations based on systematic literature reviews (SLR) and expert opinion. METHODS A task force of rheumatologists, patients and a nurse specialist assessed the SLR results and evaluated the individual items of the 2010 recommendations accordingly, reformulating many of the items. These were subsequently discussed, amended and voted upon by >40 experts, including 5 patients, from various regions of the world. Levels of evidence, strengths of recommendations and levels of agreement were derived. RESULTS The update resulted in 4 overarching principles and 10 recommendations. The previous recommendations were partly adapted and their order changed as deemed appropriate in terms of importance in the view of the experts. The SLR had now provided also data for the effectiveness of targeting low-disease activity or remission in established rather than only early disease. The role of comorbidities, including their potential to preclude treatment intensification, was highlighted more strongly than before. The treatment aim was again defined as remission with low-disease activity being an alternative goal especially in patients with long-standing disease. Regular follow-up (every 1-3 months during active disease) with according therapeutic adaptations to reach the desired state was recommended. Follow-up examinations ought to employ composite measures of disease activity that include joint counts. Additional items provide further details for particular aspects of the disease, especially comorbidity and shared decision-making with the patient. Levels of evidence had increased for many items compared with the 2010 recommendations, and levels of agreement were very high for most of the individual recommendations (≥9/10). CONCLUSIONS The 4 overarching principles and 10 recommendations are based on stronger evidence than before and are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA.
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Affiliation(s)
- Josef S Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
- 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria
| | - Ferdinand C Breedveld
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerd R Burmester
- Department of Rheumatology, Clinical Immunology Free University and Humboldt University, Charité-University Medicine, Berlin, Germany
| | - Vivian Bykerk
- Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, USA
| | - Maxime Dougados
- Department of Rheumatology B, Cochin Hospital, René Descartes University, Paris, France
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital,Leeds, UK
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | | | - Monika Schoels
- 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria
| | - Marieke Scholte-Voshaar
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | - Tanja Stamm
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Michaela Stoffer
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Daniel Aletaha
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Jose Louis Andreu
- Rheumatology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Spain
| | - Martin Aringer
- Department of Medicine III, University Medical Center TU Dresden, Dresden, Germany
| | - Martin Bergman
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Neil Betteridge
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | - Hans Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, and VU University Medical Center, Amsterdam, The Netherlands
| | - Harald Burkhardt
- Division of Rheumatology, Department of Medicine, Johann-Wolfgang-Goethe University Frankfurt, German
| | - Mario Cardiel
- Centro de Investigación Clínica de Morelia, Morelia, Michoacán, Mexico
| | - Bernard Combe
- Service d'Immuno-Rhumatologie, Montpellier University, Lapeyronie Hospital, Montpellier, France
| | - Patrick Durez
- Pôle de Recherche en Rhumatologie, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Joao Eurico Fonseca
- Rheumatology Research Unit, Instituto de de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Alan Gibofsky
- Weill Medical College, Cornell University Hospital for Special Surgery, New York, USA
| | - Juan J Gomez-Reino
- Rheumatology Unit, Santiago University Clinical Hospital, Santiago de Compostela, Spain
| | | | - Pekka Hannonen
- Department of Medicine, Central Hospital, Jyväskylä, Finland
| | | | - Marios Kouloumas
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | - Robert Landewe
- Academic Medical Center, University of Amsterdam, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands
| | | | - Peter Nash
- University of Queensland, Brisbane, Queensland, Australia
| | - Mikkel Ostergaard
- Department of Clinical Medicine, Faculty of Health Sciences, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet and Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew Östör
- Rheumatology Clinical Research Unit, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge University Hospitals, NHS Foundation Trust, Cambridge, UK
| | - Pam Richards
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | | | - Carter Thorne
- Division of Rheumatology, Southlake Regional Health Centre, Newarket, Ontario, Canada
| | | | | | - Martinus de Wit
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | - Desirée van der Heijde
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Zangi HA, Ndosi M, Adams J, Andersen L, Bode C, Boström C, van Eijk-Hustings Y, Gossec L, Korandová J, Mendes G, Niedermann K, Primdahl J, Stoffer M, Voshaar M, van Tubergen A. EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis 2015; 74:954-62. [DOI: 10.1136/annrheumdis-2014-206807] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/10/2015] [Indexed: 01/30/2023]
Abstract
ObjectivesThe task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals’ educational needs in order to provide evidence-based PE.MethodsA multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement).ResultsBased on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4–9.8). The task force proposed a research agenda and an educational agenda.ConclusionsThe eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.
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Dür M, Unger J, Stoffer M, Drăgoi R, Kautzky-Willer A, Fialka-Moser V, Smolen J, Stamm T. Definitions of occupational balance and their coverage by instruments. Br J Occup Ther 2015. [DOI: 10.1177/0308022614561235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Occupational balance is an important and widely used concept in occupational therapy and occupational science. There is, however, not one unified definition in use, but several different ones, and thus instruments that measure the concept in research studies are diverse as well. Consequently, it is unclear how instruments and definitions correspond. The purpose of this study was to examine the coverage of occupational balance definitions by occupational balance instruments. Method Within a mixed-methods design we conducted a qualitative and quantitative content analysis of definitions and items of existing instruments. Definitions and items were extracted from articles identified in a systematic literature search. The extent of congruence and coverage between definitions and instruments was examined. Results The definitions used in 47 articles were structured into 19 categories. The categories which were found in most definitions were a balance of ‘various occupational patterns and areas’ (42; 89%) and ‘occupational accomplishment, performance, roles and responsibilities’ (35; 75%); 20 instruments were explored. Together they covered 16 (84%) of the 19 categories. Conclusion Knowing which instruments cover which dimensions of occupational balance can support occupational therapists, other health professionals and health researchers in their selection of an instrument to measure occupational balance.
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Affiliation(s)
- Mona Dür
- Lecturer and Researcher, Department of Health Sciences, IMC University of Applied Sciences Krems, Austria; Lecturer, Researcher and PhD Candidate, Medical University of Vienna, Vienna, Austria
| | - Julia Unger
- Lecturer and Researcher, FH Joanneum, Bad Gleichenberg, Austria
| | - Michaela Stoffer
- Research Fellow and PhD Candidate, Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - Răzvan Drăgoi
- Assistant Professor, Department of Rehabilitation, Physical Medicine and Rheumatology, Victor Babes University of Medicine and Pharmacy, Romania
| | - Alexandra Kautzky-Willer
- Head of Gender Medicine Unit, Deputy Head of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Veronika Fialka-Moser
- Head of Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
| | - Josef Smolen
- Head of Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- University of Applied Health Sciences, Austria
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Dür M, Steiner G, Fialka-Moser V, Kautzky-Willer A, Stoffer M, Prodinger B, Dejaco C, Smolen J, Stamm T. AB1179-HPR Associations between Occupational Balance and Immunology: Differences in Health Conditions, Employment Status Und Gender. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stamm T, Duer M, Sadlonova M, Stoffer M, Haider S, Smolen J. FRI0492-HPR Life stories, gender and chronic autoimmune diseases: results of a qualitative study:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dür M, Sadloňová M, Haider S, Binder A, Stoffer M, Coenen M, Smolen J, Dejaco C, Kautzky-Willer A, Fialka-Moser V, Moser G, Stamm TA. Health determining concepts important to people with Crohn's disease and their coverage by patient-reported outcomes of health and wellbeing. J Crohns Colitis 2014; 8:45-55. [PMID: 23375212 PMCID: PMC3889494 DOI: 10.1016/j.crohns.2012.12.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/14/2012] [Accepted: 12/30/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Busy clinical settings often restrict the possibility to focus on concepts that determine health in a positive way, commonly assessed by using patient-reported outcomes (PROs). We aimed to explore which determinants of health (DHs) are important to people with Crohn's disease (CD), to understand possible gender differences and to analyze whether these DHs are covered by PROs used in CD. METHODS Two systematic literature reviews were done to identify relevant DHs and clinically relevant PROs. We conducted a qualitative narrative biographical study and mapped the patients' experiences to concepts that determine health in a positive way. Experiences, DHs and the items of the PROs were compared by the WHO International Classification of Functioning, Disability and Health (ICF) as a common framework. RESULTS 15 people with CD with a median age of 46 years (IQR 34-60) and median disease duration of 15 years (IQR 8-30) participated. Self-efficacy, social support, job satisfaction and occupational balance were mentioned most frequently. While participation appeared to have greater meaning to men, appreciation and resilience seemed to be more important for women. Of 18 PROs the Perceived Stress Questionnaire (PSQ), the Inflammatory Bowel disease - Self-efficacy scale (IBD-SES), the Life Orientation Test - Revised (LOT-R) and the Patient Activation Measure 13 (PAM-13) cover most DHs. CONCLUSIONS This is the first study elaborating the coverage of patient's perspective by commonly used PROs in CD. The findings could support health professionals to focus on DHs in people with CD in clinical practice and research.
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Affiliation(s)
- Mona Dür
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Martina Sadloňová
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Stefanie Haider
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Alexa Binder
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Michaela Stoffer
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Michaela Coenen
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany.
| | - Josef Smolen
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
| | - Clemens Dejaco
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Diabetology, Medical University of Vienna, Austria.
| | - Veronika Fialka-Moser
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria.
| | - Gabriele Moser
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.
| | - Tanja Alexandra Stamm
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Austria.
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Petersson IF, Strömbeck B, Andersen L, Cimmino M, Greiff R, Loza E, Sciré C, Stamm T, Stoffer M, Uhlig T, Woolf AD, Vliet Vlieland TPM. Development of healthcare quality indicators for rheumatoid arthritis in Europe: the eumusc.net project. Ann Rheum Dis 2013; 73:906-8. [PMID: 23960093 DOI: 10.1136/annrheumdis-2013-203765] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Eumusc.net (http://www.eumusc.net) is a European project supported by the EU and European League Against Rheumatism to improve musculoskeletal care in Europe. OBJECTIVE To develop patient-centred healthcare quality indicators (HCQIs) for healthcare provision for rheumatoid arthritis (RA) patients. METHODS Based on a systematic literature search, existing HCQIs for RA were identified and their contents analysed and categorised referring to a list of 16 standards of care developed within the eumusc.net. An international expert panel comprising 14 healthcare providers and two patient representatives added topics and during repeated Delphi processes by email ranked the topics and rephrased suggested HCQIs with the preliminary set being established during a second expert group meeting. After an audit process by rheumatology units (including academic centres) in six countries (The Netherlands, Norway, Romania, Italy, Austria and Sweden), a final version of the HCQIs was established. RESULTS 56 possible topics for HCQIs were processed resulting in a final set of HCQIs for RA (n=14) including two for structure (patient information and calculation of composite scores), 11 for process (eg, access to care, assessments, and pharmacological and non-pharmacological treatments) and one for outcome (effect of treatment on disease activity). They included definitions to be used in clinical practice and also by patients. Further, the numerators and the denominators for each HCQI were defined. CONCLUSIONS A set of 14 patient-centred HCQIs for RA was developed to be used in quality improvement and bench marking in countries across Europe.
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Affiliation(s)
- Ingemar F Petersson
- Department of Orthopedics, Clinical Sciences Lund, Lund University, , Lund, Sweden
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Stoffer M, van Bodegom-Vos L, Lund H, Vliet Vlieland T. SP0180 Health professionals workshop session: “I’ve been asked to review a clinical guideline – where do I start?”. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stoffer M, Taurok D, Prodinger B, Smolen J, Woolf A, Stamm T. FRI0488-HPR Are occupational therapy interventions included in the most commonly used european clinical-practice guidelines for the management of osteoarthritis? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dür M, Haider S, Binder A, Ernst M, Smolen JS, Drăgoi RG, Stoffer M, Dejaco C, Fialka-Moser V, Kautzky-Willer A, Stamm TA. SAT0581-HPR Occupational Challenge or Occupational Balance: Deconstruction of an Occupational Science Concept, Based on Empirical Data of a Qualitative Study in People with Rheumatic Diseases. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Moe R, Woolf A, Stoffer M, Petersson I, Uhlig T. SAT0444 Facilitators and barriers for good clinical practice in RA and OA: The eumusc.net study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stoffer M, Smolen J, Woolf A, Stamm T. OP0201-HPR Development of user- focused standards of care for rheumatoid arthritis the www.eumusc.net project - work package 5. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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