A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia
Management of rheumatoid arthritis (RA) in many Latin-American countries is impaired by fragmentation and scarce healthcare provision, resulting in obstacles to access, diagnosis, and treatment, and consequently in poor health outcomes. The aim of this study is to propose a comprehensive care progra...
- Autores:
-
Santos Moreno, Pedro Ivan
Alvis Zakzuk, Nelson Jose
Villarreal Peralta, Laura
Carrasquilla Sotomayor, María
Paternina Caicedo, Angel Jose
Alvis Guzman, Nelson Rafael
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2018
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/1667
- Acceso en línea:
- http://hdl.handle.net/11323/1667
https://repositorio.cuc.edu.co/
- Palabra clave:
- Center of excellence
Patient-centered care
Rheumatoid arthritis
Treat to target
- Rights
- openAccess
- License
- Atribución – No comercial – Compartir igual
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|
dc.title.eng.fl_str_mv |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
title |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
spellingShingle |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia Center of excellence Patient-centered care Rheumatoid arthritis Treat to target |
title_short |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
title_full |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
title_fullStr |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
title_full_unstemmed |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
title_sort |
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia |
dc.creator.fl_str_mv |
Santos Moreno, Pedro Ivan Alvis Zakzuk, Nelson Jose Villarreal Peralta, Laura Carrasquilla Sotomayor, María Paternina Caicedo, Angel Jose Alvis Guzman, Nelson Rafael |
dc.contributor.author.spa.fl_str_mv |
Santos Moreno, Pedro Ivan Alvis Zakzuk, Nelson Jose Villarreal Peralta, Laura Carrasquilla Sotomayor, María Paternina Caicedo, Angel Jose Alvis Guzman, Nelson Rafael |
dc.subject.eng.fl_str_mv |
Center of excellence Patient-centered care Rheumatoid arthritis Treat to target |
topic |
Center of excellence Patient-centered care Rheumatoid arthritis Treat to target |
description |
Management of rheumatoid arthritis (RA) in many Latin-American countries is impaired by fragmentation and scarce healthcare provision, resulting in obstacles to access, diagnosis, and treatment, and consequently in poor health outcomes. The aim of this study is to propose a comprehensive care program as a model to provide healthcare to RA patients receiving synthetic DMARDs in a Colombian setting by describing the model and its results. Health outcomes were prospectively collected in all patients entering the program. By protocol, patients are followed up during 24 months using a treat-to-target strategy with a patient-centered care (PCC) model, meaning that a patient should be seen by rheumatologist, physical and occupational therapist, physiatrist, nutritionist and psychologist, at least three times a year according to disease activity by DAS28. Otherwise, patients receive standard therapy. The incidence of remission and low disease activity (LDA) was calculated by periods of follow-up. A total of 968 patients entered the program from January 2015 to December 2016; 80.2% were women. At baseline, 41% of patients were in remission, 17% in LDA and 42% in MDS/SDA. At 24 months of follow-up, 66% were in remission, 18% in LDA and only 16% in MDS/SDA. Regarding DAS28, the mean at the beginning of the time analysis was 3.1 (SD 1.0) and after 24 months it was 2.4 (SD 0.7), showing a statistically significant improvement (p < 0.001). In all patients, the reduction of disease activity was 65% (95% CI, 58–71). Patients entering the PCC program benefited from a global improvement in disease activity in terms of DAS28. |
publishDate |
2018 |
dc.date.accessioned.none.fl_str_mv |
2018-11-21T20:19:09Z |
dc.date.available.none.fl_str_mv |
2018-11-21T20:19:09Z |
dc.date.issued.none.fl_str_mv |
2018-03-01 |
dc.type.spa.fl_str_mv |
Artículo de revista |
dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_6501 |
dc.type.content.spa.fl_str_mv |
Text |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/ART |
dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
format |
http://purl.org/coar/resource_type/c_6501 |
status_str |
acceptedVersion |
dc.identifier.issn.spa.fl_str_mv |
01728172 |
dc.identifier.uri.spa.fl_str_mv |
http://hdl.handle.net/11323/1667 |
dc.identifier.doi.spa.fl_str_mv |
DOI: 10.1007/s00296-017-3903-2 |
dc.identifier.instname.spa.fl_str_mv |
Corporación Universidad de la Costa |
dc.identifier.reponame.spa.fl_str_mv |
REDICUC - Repositorio CUC |
dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.cuc.edu.co/ |
identifier_str_mv |
01728172 DOI: 10.1007/s00296-017-3903-2 Corporación Universidad de la Costa REDICUC - Repositorio CUC |
url |
http://hdl.handle.net/11323/1667 https://repositorio.cuc.edu.co/ |
dc.language.iso.none.fl_str_mv |
eng |
language |
eng |
dc.rights.spa.fl_str_mv |
Atribución – No comercial – Compartir igual |
dc.rights.accessrights.spa.fl_str_mv |
info:eu-repo/semantics/openAccess |
dc.rights.coar.spa.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
rights_invalid_str_mv |
Atribución – No comercial – Compartir igual http://purl.org/coar/access_right/c_abf2 |
eu_rights_str_mv |
openAccess |
dc.publisher.spa.fl_str_mv |
Rheumatology International |
institution |
Corporación Universidad de la Costa |
bitstream.url.fl_str_mv |
https://repositorio.cuc.edu.co/bitstream/11323/1667/1/A%20Comprehensive%20Care%20Program%20Achieves.pdf https://repositorio.cuc.edu.co/bitstream/11323/1667/2/license.txt https://repositorio.cuc.edu.co/bitstream/11323/1667/4/A%20Comprehensive%20Care%20Program%20Achieves.pdf.jpg https://repositorio.cuc.edu.co/bitstream/11323/1667/5/A%20Comprehensive%20Care%20Program%20Achieves.pdf.txt |
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Santos Moreno, Pedro Ivanb72f970ada5db87243a728d23c32b87aAlvis Zakzuk, Nelson Josee8e4e8b7760b42a826bf860af8dba139Villarreal Peralta, Laura099fe9a5ad420ee57bb3403b38c45a92Carrasquilla Sotomayor, Maríaa72e1875265eedb090ed9210388404fcPaternina Caicedo, Angel Jose5772d8b5c928bdf3c863f3d060ade1cbAlvis Guzman, Nelson Rafael6248ccf71d6d3b55f5c54cca9315c03a2018-11-21T20:19:09Z2018-11-21T20:19:09Z2018-03-0101728172http://hdl.handle.net/11323/1667DOI: 10.1007/s00296-017-3903-2Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Management of rheumatoid arthritis (RA) in many Latin-American countries is impaired by fragmentation and scarce healthcare provision, resulting in obstacles to access, diagnosis, and treatment, and consequently in poor health outcomes. The aim of this study is to propose a comprehensive care program as a model to provide healthcare to RA patients receiving synthetic DMARDs in a Colombian setting by describing the model and its results. Health outcomes were prospectively collected in all patients entering the program. By protocol, patients are followed up during 24 months using a treat-to-target strategy with a patient-centered care (PCC) model, meaning that a patient should be seen by rheumatologist, physical and occupational therapist, physiatrist, nutritionist and psychologist, at least three times a year according to disease activity by DAS28. Otherwise, patients receive standard therapy. The incidence of remission and low disease activity (LDA) was calculated by periods of follow-up. A total of 968 patients entered the program from January 2015 to December 2016; 80.2% were women. At baseline, 41% of patients were in remission, 17% in LDA and 42% in MDS/SDA. At 24 months of follow-up, 66% were in remission, 18% in LDA and only 16% in MDS/SDA. Regarding DAS28, the mean at the beginning of the time analysis was 3.1 (SD 1.0) and after 24 months it was 2.4 (SD 0.7), showing a statistically significant improvement (p < 0.001). In all patients, the reduction of disease activity was 65% (95% CI, 58–71). Patients entering the PCC program benefited from a global improvement in disease activity in terms of DAS28.engRheumatology InternationalAtribución – No comercial – Compartir igualinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Center of excellencePatient-centered careRheumatoid arthritisTreat to targetA comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. 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