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.
The Preliminary Testing of a Core Set To Monitor SLE Patients in Routine Clinical Practice.
Mosca6, Marta, Tani6, Chiara, Quaglierini6, Federico, Goehner5, Katia, Costa2, Joao Matos, Psenak3, Oskar, Szmyrka-Kaczmarek7, Magdalena
Chiang Mai, University, Thailand
Hospital de Santarem, Portugal
Saltzbugr University, Austria
University Hospital, Krakow, Poland
University Hospital, Zurich, Switzerland
University of Pisa, Italy
Wroclaw University, Poland
Systemic lupus erythematosus (SLE) is a complex disease; patient assessment in clinical practice mainly relies upon the experience of the treating physician and thus is subject to great variability. Unexplained variability may affect health care and lead to poor outcomes and complicates comparisons among practices. Recently "EULAR Recommendations for monitoring SLE patients in clinical practice and in observational studies" have been published. In addition a core set of minimal assessments to evaluate SLE patients in clinical practice was developed. The strength of this core set is represented by the fact that it was developed by combining available evidence and expert opinion, it includes only feasible variables and can be easily done in routine clinical practice.
Aim of the Study:
Aim of the present study was to preliminary test the feasibility of this core set in routine clinical practice and to develop a computerized data base to collect patient's data.
Seven centres (Austria, Italy, 2 Poland, Portugal, Switzerland, Thailand) participated to the study and were asked to collect data of at least 5 consecutive SLE patients during routine assessment.
Sixty-five patients were enrolled (55 Caucasians and 10 Asians; F: 64; M: 1; mean age 41 years), on average 10 minutes were required to fill the chart of the core set, although the time required appeared related with the type of organ involvement.
Disease activity using validated indices was calculated in all patients in routine clinical practice (ECLAM (15 patients): mean 2, SLEDAI (50 patients): mean 5), while the SLICC/ACR damage index (mean value 1) and the quality of life were evaluated only in 49% of patients. With respect to the adherence to recommendations, interestingly, this preliminary analysis showed that 86% of patients treated with immunosuppressive drugs had been assessed for the presence of chronic HBV and HCV infections and only 38% for tuberculosis. In addition, 15% of patients had never been assessed for osteoporosis or for lipid profile.
Following this preliminary testing, and based on the participants comments and suggestions, a Web based data base has been developed to collect data on SLE patients using the core set chart and including the ECLAM and SELENA- SLEDAI and the SLICC/ACR damage index. Recorded data can be downloaded and used for additional statistical analysis.
These preliminary data show that the use of a standardized core set in routine clinical practice is feasible and could represent a tool to reduce variability in data collection and to increase adherence to recommendations in clinical practice and therefore could lead to improvement of quality of care and of data travelling.
To cite this abstract, please use the following information:
Mosca, Marta, Tani, Chiara, Quaglierini, Federico, Goehner, Katia, Costa, Joao Matos, Psenak, Oskar, et al; The Preliminary Testing of a Core Set To Monitor SLE Patients in Routine Clinical Practice. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1011