Tal Gazitt1, Shirley Oren2, Tatiana Reitblat3, Merav Lidar4, Alexandra Balbir Gurman5, Itzhak Rosner6, Nimer Halabe7, Joy Feld1, Sameer Kassem7, Idit Lavi8, Ori Elkayam9, Devy Zisman1. 1. Department of Rheumatology, Carmel Medical Center, Haifa, Israel. 2. Department of Rheumatology, Rabin Medical Center, Petah Tikva, Israel. 3. Department of Rheumatology, Barzilai Medical Center, Ashkelon, Israel. 4. Rheumatology Unit, Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Aviv, Israel. 5. B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel. 6. Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel. 7. Department of Internal Medicine, Carmel Medical Center, Haifa, Israel. 8. Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel. 9. Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Abstract
OBJECTIVE: We aimed to assess the implementation of the treat-to-target (T2T) concept in rheumatoid arthritis (RA) patients in daily practice. METHODS: All RA patients visiting one of the 7 academic medical centers in Israel in June 2015 with at least 3 previous clinic visits were included in this study. A common questionnaire was used to collect data from patients' medical records, and two independent rheumatologists evaluated the collected data for the implementation of the T2T concept. The associations between T2T implementation and the categorical and continuous variables were assessed. RESULTS: The study included 724 patients with a mean (standard deviation) age of 62.6 (13.97) years and 575 (80.4%) of them were women. Four centers used more than one scoring method, with Disease Activity Score-28 and Clinical Disease Activity Index) being most commonly used. Only 276 (38.1%) patients had disease score results in ≥3 visits, and the T2T recommendations were implemented for 245 (33.8%) of the 724 patients. The rate of implementation was higher in younger (p=0.028) rheumatoid factor-positive patients (p=0.011) and varied between centers (11.1%-87% p<0.0001). T2T implementation did not correlate to gender, place of residence, education, tobacco use, treatment regimens, and presence of erosions or comorbidities. CONCLUSION: The T2T concept was implemented on only 33.8% of patients and was not affected by RA disease severity. Further studies are needed to determine the reasons for this deviation from the T2T standard of care for RA as well as its consequences.
OBJECTIVE: We aimed to assess the implementation of the treat-to-target (T2T) concept in rheumatoid arthritis (RA) patients in daily practice. METHODS: All RApatients visiting one of the 7 academic medical centers in Israel in June 2015 with at least 3 previous clinic visits were included in this study. A common questionnaire was used to collect data from patients' medical records, and two independent rheumatologists evaluated the collected data for the implementation of the T2T concept. The associations between T2T implementation and the categorical and continuous variables were assessed. RESULTS: The study included 724 patients with a mean (standard deviation) age of 62.6 (13.97) years and 575 (80.4%) of them were women. Four centers used more than one scoring method, with Disease Activity Score-28 and Clinical Disease Activity Index) being most commonly used. Only 276 (38.1%) patients had disease score results in ≥3 visits, and the T2T recommendations were implemented for 245 (33.8%) of the 724 patients. The rate of implementation was higher in younger (p=0.028) rheumatoid factor-positive patients (p=0.011) and varied between centers (11.1%-87% p<0.0001). T2T implementation did not correlate to gender, place of residence, education, tobacco use, treatment regimens, and presence of erosions or comorbidities. CONCLUSION: The T2T concept was implemented on only 33.8% of patients and was not affected by RA disease severity. Further studies are needed to determine the reasons for this deviation from the T2T standard of care for RA as well as its consequences.
Authors: L R Lard; H Visser; I Speyer; I E vander Horst-Bruinsma; A H Zwinderman; F C Breedveld; J M Hazes Journal: Am J Med Date: 2001-10-15 Impact factor: 4.965
Authors: Paul M Ridker; Eleanor Danielson; Francisco A H Fonseca; Jacques Genest; Antonio M Gotto; John J P Kastelein; Wolfgang Koenig; Peter Libby; Alberto J Lorenzatti; Jean G MacFadyen; Børge G Nordestgaard; James Shepherd; James T Willerson; Robert J Glynn Journal: N Engl J Med Date: 2008-11-09 Impact factor: 91.245
Authors: J S Smolen; C Han; D M F M van der Heijde; P Emery; J M Bathon; E Keystone; R N Maini; J R Kalden; D Aletaha; D Baker; J Han; M Bala; E W St Clair Journal: Ann Rheum Dis Date: 2008-07-01 Impact factor: 19.103
Authors: Paul Emery; Ferdinand C Breedveld; Stephen Hall; Patrick Durez; David J Chang; Deborah Robertson; Amitabh Singh; Ronald D Pedersen; Andrew S Koenig; Bruce Freundlich Journal: Lancet Date: 2008-07-16 Impact factor: 79.321
Authors: Tuulikki Sokka; Merete Lund Hetland; Heidi Mäkinen; Hannu Kautiainen; Kim Hørslev-Petersen; Reijo K Luukkainen; Bernard Combe; Humeira Badsha; Alexandros A Drosos; Joe Devlin; Gianfranco Ferraccioli; Alessia Morelli; Monique Hoekstra; Maria Majdan; Stefan Sadkiewicz; Miguel Belmonte; Ann-Carin Holmqvist; Ernest Choy; Gerd R Burmester; Recep Tunc; Aleksander Dimić; Jovan Nedović; Aleksandra Stanković; Martin Bergman; Sergio Toloza; Theodore Pincus Journal: Arthritis Rheum Date: 2008-09
Authors: Marieke J Spijk-de Jonge; Julia M Weijers; Marlies E J L Hulscher; Piet L C M van Riel; Laura W M Boerboom; Anita M P Huis; Femke Atsma; Laura T C Van Hulst; Mart A F J van de Laar Journal: Clin Rheumatol Date: 2020-01-29 Impact factor: 2.980
Authors: Johanna Mucke; Johannes Knitza; Felix Muehlensiepen; Manuel Grahammer; Ramona Stenzel; David Simon; Arnd Kleyer; Gerhard Krönke; Charlotte Sharp; Gerlinde Bendzuck; Marianne Korinth; Corinna Elling-Audersch; Nicolas Vuillerme; Georg Schett; Ann-Christin Pecher; Martin Krusche Journal: Front Med (Lausanne) Date: 2021-12-13
Authors: Martin Krusche; Philipp Klemm; Manuel Grahammer; Johanna Mucke; Diana Vossen; Arnd Kleyer; Philipp Sewerin; Johannes Knitza Journal: JMIR Mhealth Uhealth Date: 2020-07-20 Impact factor: 4.773