1
|
Martín-Martínez MA, Andreu-Sanchez JL, Sanchez-Alonso F, Corominas H, Perez-Venegas JJ, Roman-Ivorra JA, Alperi M, Blanco-Alonso R, Caliz R, Chamizo-Carmona E, Graña-Gil J, Hernández B, Marras C, Mazzucchelli R, Medina Luezas JA, Naranjo-Hernández A, Ortiz A, Roselló R, Sanchez-Nievas G, Sanmartí R, Vela-Casasempere P. A composite indicator to assess the quality of care in the management of patients with rheumatoid arthritis in outpatient rheumatology clinics. ACTA ACUST UNITED AC 2017; 15:156-164. [PMID: 28789978 DOI: 10.1016/j.reuma.2017.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The current guidelines in the treatment of rheumatoid arthritis (RA) include the early diagnosis and early use of disease modifying drugs to achieve remission or low disease activity level, known as "Treat to Target" (T2T). The objective of this study is to develop a composite indicator (CI) to evaluate the quality of care in the management of patients with RA, according to the T2T strategy and other general recommendations concerning the management of these patients. MATERIAL AND METHOD The phases of the construction of the CI were: 1) selection of quality criteria through expert judgment; 2) prioritization of the criteria, according to relevance and feasibility, applying the Delphi methodology (two rounds) involving 20 experts; 3) design of quality indicators; and 4) calculation of the weighted CI, using the mean value in relevance and feasibility granted by the experts. The source of information for the calculation of the CI are the medical records of patients with RA. RESULTS Twelve criteria out of 37 required a second Delphi round. Thirty-one criteria were prioritized. These criteria presented a median in relevance and feasibility greater than or equal to 7.5, with an interquartile range of less than 3.5, and a level of agreement (score greater than or equal to 8) greater than or equal to 80%. CONCLUSIONS The constructed CI allows us to evaluate the quality of care of patients with RA following the T2T strategy in the rheumatology units of Spanish hospitals, offering a valid and easily interpretable summary measure.
Collapse
Affiliation(s)
| | | | | | - Hector Corominas
- Servicio de Reumatología, Hospital de Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, España
| | - Jose Javier Perez-Venegas
- Servicio de Reumatología, Hospital General de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España
| | | | - Mercedes Alperi
- Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Ricardo Blanco-Alonso
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Rafael Caliz
- Servicio de Reumatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | | | - Jenaro Graña-Gil
- Servicio de Reumatología, Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | - Blanca Hernández
- Servicio de Reumatología, Hospital Universitario Virgen de la Macarena, Sevilla, España
| | - Carlos Marras
- Servicio de Reumatología, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Ramon Mazzucchelli
- Servicio de Reumatología, Fundación Hospital Alcorcón, Alcorcón, Madrid, España
| | | | - Antonio Naranjo-Hernández
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España
| | - Ana Ortiz
- Servicio de Reumatología, Hospital Universitario La Princesa, Madrid, España
| | - Rosa Roselló
- Servicio de Reumatología, Hospital San Jorge, Huesca, España
| | - Ginés Sanchez-Nievas
- Servicio de Reumatología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - Raimon Sanmartí
- Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, España
| | | |
Collapse
|