Rheumatoid arthritis quality measures and radiographic progression |
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Authors: | Sonali P. Desai MD MPH Chih-Chin Liu Heather Tory Tabatha NortonSiri Lillegraven MD MPH Michael Weinblatt Jonathan Coblyn Jinoos Yazdany Nancy Shadick Daniel H. Solomon |
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Affiliation: | 1. Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham & Women’s Hospital, 75 Francis St, PBB-B3, Boston, MA 02115;2. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway;3. Division of Rheumatology, Department of Medicine, University of San Francisco, San Francisco, CA;4. Division of Pharmacoepidemiology, Brigham and Women’s Hospital, Boston, MA |
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Abstract: | ObjectiveDocumentation of quality measures (QMs) in rheumatoid arthritis (RA) is used as a surrogate for measure of quality of care, but the association of this documentation with radiographic outcomes is uncertain. We examined documentation of RA QMs, for disease activity and functional status and the association with radiographic outcomes.MethodsData were analyzed for 438 RA patients in a longitudinal cohort with complete data on van der Heijde-modified Total Sharp Score (TSS). All rheumatologist (N = 18) notes in the electronic medical record during a 24-month period were reviewed for RA QMs. Any mention of disease activity categorized as low, moderate, or high was considered documentation of the QM for disease activity. Functional status QM documentation included any mention of the impact of RA on function. Change in TSS was quantified with progression defined as ≥1 unit per year. We compared percent of visits with an RA QM documented and mean change in TSS.ResultsThe mean age in the cohort was 56.9 years, disease duration was 10.8 years, baseline DAS28 score was 3.8 (±1.6), 67.7% were seropositive, and 33.9% used a biologic DMARD. Radiographic progression was observed in 28.5%. Disease activity was documented for 29.0% of patient visits and functional status in 74.7%; neither had any significant relationship to mean TSS change (both P > 0.10).ConclusionThe documentation of RA QMs was infrequent and not associated with radiographic outcomes over 24 months. |
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Keywords: | Rheumatoid arthritis Quality measures Radiographic progression |
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