Nov 5, 2011

Effectiveness of a clinical practice intervention in early rheumatoid arthritis

Arthritis Care & Research
M A DescalzoSERAP and PROAR Study Groups


To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics. We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp/van der Heijde radiologic score using marginal structural models. A total of 161 early RA patients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of -0.24 (95% confidence interval [95% CI] -0.39, -0.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of -0.05 (95% CI -0.09, -0.01) uni...Continue Reading

  • References29
  • Citations10


  • References29
  • Citations10


Mentioned in this Paper

Primary Health Care
Antirheumatic Drugs, Disease-Modifying
Articular System
Severity of Illness Index
Incidence Studies
Rheumatoid Arthritis
Protective Factors
Health Assessment Questionnaire
Rheumatology Specialty

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