Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

A Model for the Development and Implementation of a National Plan for the Optimal Management of Early Spondyloarthritis: The Esperanza Program.

Gobbo1,  Milena, Schiotis9,  Ruxandra, Munoz-Fernandez8,  Santiago, Carmona1,  Loreto, Collantes5,  Eduardo, Miguel6,  Eugenio de, Garcia-Yebenes1,  M. Jesús

Research Unit, Sociedad Espanola de Reumatología. Madrid, Spain
Rheumatology Department, Fundación Hospital de Alcorcón, Madrid, Spain
Rheumatology Department, Hospital de Basurto
Rheumatology Department, Hospital Puerta de Hierro Majadahonda. Madrid, Spain
Rheumatology Department, Hospital Reina Sofía. Córdoba, Spain
Rheumatology Department, Hospital Universitario La Paz. Madrid, Spain
Rheumatology Unit, Hospital General de Elda. Elda, Spain
Rheumatology Unit, Hospital Infanta Sofía. San Sebastián de los Reyes, Madrid. Spain
University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania

The design of a program in early spondyloarthritis (SpA) should have the following objectives: 1) to enable the establishment of early SpA units, 2) to facilitate early diagnosis; 3) to reduce the variability in SpA; and 4) to improve the knowledge and practical skills on SpA of general practitioners (GPs) and specialists.


The Esperanza Program includes: 1) a call for the creation of 25 early SpA units with specific requirements; 2) the establishment of a managed care plan with 8 measurable indicators; 3) a web-based platform which may function as an electronic medical record (EMR), and which permits evaluation, and facilitates networking and feed-back; and 4) educational initiatives.


Evaluation of the 25 implemented units covers from April 2008 until October 15th 2009. As of last evaluation, 1812 GPs were participating and 792 patients had been referred by their GPs. Indicators' values: 1) Over 90% of the patients have been attended within 30 days since their visit to PC; 2) the reliability of the referrals was 92%; 3) 53% of first visits had a duration of 30 to 60 minutes; 4) 28% of the patients had a diagnosis of SpA already in the first visit; 5) a report was issued in 25% of the medical visits; 6) 2% of the electronic reports issued were consulted by the GPs; 7) missing data in the EMR was 24%; and 8) an appropriate frequency of revisions was met in 84% of the patients. The patients attended were evenly distributed among sexes, and most of them were active workers. Their disease was active but spinal mobility and structural changes were preserved.


It is possible to implement a large scale program that is measurable and that helps to improve the management of early disease.

To cite this abstract, please use the following information:
Gobbo, Milena, Schiotis, Ruxandra, Munoz-Fernandez, Santiago, Carmona, Loreto, Collantes, Eduardo, Miguel, Eugenio de, et al; A Model for the Development and Implementation of a National Plan for the Optimal Management of Early Spondyloarthritis: The Esperanza Program. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :986
DOI: 10.1002/art.28753

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