Author/Editor     Meisters, Rachelle; Putrik, Polina; Ramiro, Sofia; Hifinger, Monika; Keszei, Andras P; Eijk-Hustings, Yvonne; Woolf, Anthony Derek; Smolen, Josef S.; Tomšič, Matija
Title     EULAR/eumusc.net standards of care for rheumatoid arthritis
Type     članek
Vol. and No.     Letnik 79Letnik 11
Publication year     2020
Volume     str. 1423-1431
ISSN     0003-4967 - Annals of the Rheumatic Diseases
Language     eng
Abstract     Objective As part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe. Methods Two cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0-10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0-100, maximal gap). Factors associated with the problematic care gaps (ie, gap>-30 and importance>-6 and implementation<6) and strong barriers (<-6) were further analysed in multilevel logistic regression models. Results Overall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients. Conclusions Many problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.
Keywords     rheumatoid arthritis
standards of care
European countries
revmatoidni artritis
standardi oskrbe
evropske države