Due to appointment scheduling and insurer requirements, a 14-month window seems optimal for measuring follow-up, the researchers write. However, they also note that more research is needed to determine if adherence to a 12- vs. a 14-month window of follow-up affects patient outcomes.
In the study, the percentage of DMARD-treated early RA patients was and remained high (95–87%). Additionally, the percentage of patients receiving DMARDs within 14 days of diagnosis was 75%. Median time-to-DMARD therapy was one day, indicating DMARDs were initiated at diagnosis. Prior research links delays in starting DMARD therapy to worse outcomes for patients. “Most significant delays to therapy occur due to delays in access to rheumatology [care] and time-to-DMARD start [after] a patient is seen by a rheumatologist is often negligible, a finding confirmed by our study,” note the authors.
The authors conclude by noting that testing performance measures is crucial prior to implementation. “Additionally, future studies examining patient and provider factors that impact measure performance will be important to conduct, to better understand how to improve any observed gaps in care. [Although] the rates of adherence in this cohort were high, lower adherence will perhaps be observed with other data sources, but the current results may be used in benchmarking.”
Barber CEH, Schieir O, Lacaille D, et al. High adherence to system-level performance measures for rheumatoid arthritis in a national early arthritis cohort over eight years. Arthritis Care Res (Hoboken). 2018 Jun;70(6):842–850.