High Adherence to System‐Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years |
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| Authors: | Claire E. H. Barber Orit Schieir Diane Lacaille Deborah A. Marshall Cheryl Barnabe Glen Hazlewood J. Carter Thorne Vandana Ahluwalia Susan J. Bartlett Gilles Boire Boulos Haraoui Carol Hitchon Edward Keystone Diane Tin Janet E. Pope Lisa Denning Vivian P. Bykerk Canadian Early Arthritis Cohort Investigators |
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| Affiliation: | 1. University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada;2. University of Toronto, Toronto, Ontario, Canada;3. Arthritis Research Canada, Richmond, and University of British Columbia, Vancouver, British Columbia, Canada;4. Southlake Regional Health Centre, Newmarket, Ontario, Canada;5. William Osler Health System, Etobicoke, Ontario, Canada;6. McGill University Health Centre, Montreal, Quebec, Canada;7. Université de Sherbrooke, Sherbrooke, Quebec, Canada;8. University of Montreal, Montreal, Quebec, Canada;9. University of Manitoba, Winnipeg, Manitoba, Canada;10. University of Western Ontario, London, Ontario, Canada;11. Arthritis Research Canada, Richmond, British Columbia, Canada, and Hospital for Special Surgery, New York, New York |
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| Abstract: | Objective To assess adherence to 3 system‐level performance measures in a national early rheumatoid arthritis (RA) cohort. Methods Patients enrolled in the Canadian Early Arthritis Cohort (2007–2015) who met 1987 or 2010 American College of Rheumatology/European League Against Rheumatism criteria with <1 year of symptom duration and ≥1 year of followup after enrollment were included. Performance measures assessed were the percentage of RA patients seen in yearly followup, and the number of gaps between visits of >12 or >14 months, the percentage of RA patients treated with a disease‐modifying antirheumatic drug (DMARD), and days from RA diagnosis to initiation of a DMARD. Results are shown stratified by enrollment year to assess for temporal changes in performance. Results A total of 1,763 early RA patients were included (mean age 54 years, 73% female, and 82% white). At enrollment, mean ± SD disease duration was 6 ± 3 months, and Disease Activity Score in 28 joints was 5.1 ± 1.5. Over 8 years, the proportion of patients seen in annual followup declined from 100% to 91%. Over followup, 42% of patients had 0 gaps in care of >12 months, and 64% had 0 gaps >14 months. The percentage of DMARD‐treated early RA patients was and remained high (95–87%), and the percentage receiving DMARDs within 14 days of diagnosis was 75%. Median time‐to‐DMARD therapy was 1 day, indicating DMARDs were initiated at diagnosis (90th percentile 93 days). Conclusion There was evidence of high adherence to system‐level performance measures in this early RA cohort following a protocol. Small declines in performance were noted with increasing length of patient followup. Our findings are useful for performance measure benchmarking. |
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