Implementation of Treat-to-Target in Rheumatoid Arthritis Through a Learning Collaborative: Results of a Randomized Controlled Trial

Arthritis & Rheumatology
Daniel H SolomonJeffrey N Katz

Abstract

Treat-to-target (TTT) is an accepted paradigm for the management of rheumatoid arthritis (RA), but some evidence suggests poor adherence. The purpose of this study was to test the effects of a group-based multisite improvement learning collaborative on adherence to TTT. We conducted a cluster-randomized quality-improvement trial with waitlist control across 11 rheumatology sites in the US. The intervention entailed a 9-month group-based learning collaborative that incorporated rapid-cycle improvement methods. A composite TTT implementation score was calculated as the percentage of 4 required items documented in the visit notes for each patient at 2 time points, as evaluated by trained staff. The mean change in the implementation score for TTT across all patients for the intervention sites was compared with that for the control sites after accounting for intracluster correlation using linear mixed models. Five sites with a total of 23 participating rheumatology providers were randomized to intervention and 6 sites with 23 participating rheumatology providers were randomized to the waitlist control. The intervention included 320 patients, and the control included 321 patients. At baseline, the mean TTT implementation score was 11...Continue Reading

Associated Clinical Trials

References

Mar 23, 2002·Annual Review of Public Health·Thomas LumleyLu Chen
Apr 16, 2002·Arthritis and Rheumatism·Timo MöttönenUNKNOWN FIN-RACo Trial Group. FINnish Rheumatoid Arthritis Combination therapy
Apr 17, 2004·Joint Commission Journal on Quality and Safety·Rob BenedettiMelissa Ahern
Mar 23, 2005·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·Rita Mangione-SmithEmmett Keeler
May 4, 2005·Archives of Pediatrics & Adolescent Medicine·Charles J HomerPatricia Heinrich
Mar 21, 2007·Annals of Internal Medicine·Yvonne P M Goekoop-RuitermanBen A C Dijkmans
Jun 26, 2008·BMJ : British Medical Journal·Loes M T SchoutenRichard P T M Grol
Mar 11, 2010·Annals of the Rheumatic Diseases·Josef S SmolenUNKNOWN T2T Expert Committee
Mar 20, 2010·Annals of the Rheumatic Diseases·Monika SchoelsJosef S Smolen
Apr 2, 2013·The Cochrane Database of Systematic Reviews·Scott ReevesMerrick Zwarenstein
Aug 29, 2013·Arthritis Care & Research·Kathleen TymmsGeoffrey Littlejohn
May 15, 2015·Annals of the Rheumatic Diseases·Josef S SmolenDesirée van der Heijde

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Citations

Jan 5, 2019·Current Opinion in Rheumatology·Lucy H LiuJinoos Yazdany
Sep 11, 2019·Journal of Clinical Medicine·Bogdan BatkoZbigniew Żuber
Jul 17, 2019·The Journal of Rheumatology·Lisa BuckleyJon M Burnham
Dec 18, 2019·Annals of the Rheumatic Diseases·Josef S Smolen
Feb 20, 2020·RMD Open·Emma DuresLaura C Coates
Feb 1, 2019·Nature Reviews. Rheumatology·Ronald van Vollenhoven

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