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.
Using an Electronic Data Capture System To Measure Outcomes in Patients on Biologic DMARD Therapy: The Rheumatology Health Tracker (RHT).
Narayanan1, Sita A., Lisse2, Jeffrey R., Alvarez4, Alexis A., Lo Rafael G. Grau3, Catherine, Gall2, Eric P., Furet4, Oscar
Patient outcomes are increasingly important to track the response to disease modifying drugs (DMARD) over time. The Rheumatology Health Tracker (RHT) is an electronic capture system that tracks the outcomes in patients with rheumatoid arthritis on different biologic DMARDS over time in a real world setting, and can be important in detecting outcomes. This report evaluated outcome measures for a patient population undergoing biologic DMARD therapy after a second year of analyzing RHT use in an academic rheumatology clinic.
Patients with rheumatoid arthritis were already participating in an observational study using a web based electronic capture system. After informed consent, at each visit they were asked to record the following outcome parameters: Involved Joint Count (IJC), Short Form 12 (SF-12), Health Assessment Questionnaire (HAQ), and Visual Analog Scale of their overall disease activity (VAS), demographic information, and information on health care utilization. Practitioners then filled out a Tender Joint Count (TJC), Swollen Joint Count (SJC), and a visual analog scale. These outcomes were analyzed after a year and found to be statistically and clinically stable. A second annual analysis was performed on the same biologics with inclusion of newly consented patients resulting in a larger sample size.
There were 155 patients enrolled in the study who were on biologic DMARDs. Overall HAQ was 0.824, SJC was 5.062, TJC was 6.662, SF-12 was 35.302, and VAS was 24.175. Initial baseline HAQ scores for the different biologics was 0.5547 for etanercept (n=41), 0.9184 for infliximab (n=39), 0.642 for adalimumab (n=41), 0.99 for rituximab (n=20), and 1.18 for abatacept (n=14). The change in HAQ score between the initial visit and the first follow up visit was +0.175 for etanercept, -0.088 for rituximab, -0.218 for infliximab, +0.121 for adalimumab, and -0.151 for abatacept. SF12 scores all increased however infliximab, rituximab, and abatacept showed the most improvement in patient-perceived health status.
Electronic medical records offer a means to record outcome parameters in patients on biologic DMARDs in a clinic outpatient setting over time. This reflects the use of different biologics in our practice. This second annual analysis showed the utility of using this system over time to record patient and physician reported outcomes.This allows long-term monitoring of patients on biologic DMARDs with the RHT, and gives physicians the opportunity to adjust treatment accordingly. It is an accessible, reproducible electronic information source that can be accessed by multiple practitioners to assess and treat their patients over time.
To cite this abstract, please use the following information:
Narayanan, Sita A., Lisse, Jeffrey R., Alvarez, Alexis A., Lo Rafael G. Grau, Catherine, Gall, Eric P., Furet, Oscar; Using an Electronic Data Capture System To Measure Outcomes in Patients on Biologic DMARD Therapy: The Rheumatology Health Tracker (RHT). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1014