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Objective: To develop and assess the feasibility in daily practice of four comorbidity checklists, for common use in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Methods: A multidisciplinary panel of experts on comorbidity was established. Data from the GECOAR, GECOAX and GECOAP projects were analysed and a narrative literature review in Medline on RA, axSpA and PsA comorbidity was performed in order to select the most relevant and common comorbidities across the three diseases. With these results and those obtained from a focus group of patients, in a nominal group meeting, the experts generated preliminary checklists. These were afterwards modified by an external evaluation by two associations, a patients’ association and an association of health professionals related to rheumatology. As a result, the final checklists were generated. A cross-sectional study was conducted to test the feasibility of three of the checklists in daily practice, in which eight health professionals evaluated the checklists in five patients with RA, five with axSpA and five with SpA. Results: Four comorbidity checklists were designed, three for health professionals (one to assess current comorbidity, one on prevention/health promotion and one with the referral criteria to other health professionals), and another for patients. The feasibility study showed them to be simple, clear, and useful for use in routine clinical practice. Conclusions: The use of specific and common checklists for patients with RA, axSpA and PsA is feasible and might contribute favorably to their prognosis as well as in daily practice., Este proyecto fue financiado por Merck Sharp & Dohme® España y avalado por las siguientes asociaciones/sociedades: CONARTRITIS (Coordinadora Nacional de Artritis asociación, de pacientes que representa a las personas afectadas por AR, APs, AIJ y EspA), OPENREUMA (Asociación de otros profesionales sanitarios dedicados a la reumatología) y SORCOM (Sociedad de Reumatología de la Comunidad de Madrid)

Resumen Objetivos Identificar las comorbilidades prioritarias en la espondiloartritis axial (EspAx) y recomendar como hacer su seguimiento desde una perspectiva eminentemente practica. Metodos Se selecciono a un grupo multidisciplinar (10 reumatologos [6 expertos en EspAx], 2 medicos de familia, una internista, una cardiologa, una gastroenterologa y una psicologa). En una primera reunion de discusion, se establecieron el alcance y los usuarios, y se voto una lista de comorbilidades sobre la base de la frecuencia y el impacto. Los panelistas debian defender con argumentos consistentes la inclusion de cada comorbilidad/item en el documento. Cuatro panelistas y 2 metodologos, desarrollaron revisiones sistematicas en temas controvertidos. En una segunda reunion se presentaron los resultados de las revisiones y los argumentos de todos los items a incluir. Tras esta reunion se redacto el documento final. Resultados El documento final incluye 2 listas de comprobacion (checklist), una para profesionales sanitarios y otra para pacientes, que recogen: riesgo cardiovascular, comorbilidad renal, riesgo gastrointestinal, estilo de vida, riesgo de infecciones y vacunacion, afectacion pulmonar, medicacion concomitante, trastornos psicoafectivos, osteoporosis y riesgo de fractura. Ademas, el documento refleja los argumentos para incluir cada item y la manera de recoger los items. Asimismo, el panel considero oportuno establecer unas «practicas a evitar» aplicables a la comorbilidad de la EspAx. Conclusiones Se generaron 2 listas de comprobacion y un listado de escenarios a evitar para facilitar el manejo de las comorbilidades de la EspAx. En pasos posteriores probaremos su utilidad y su aceptacion por un grupo amplio de usuarios que incluya medicos, pacientes y enfermeras.

Resumen Objetivo Estimar los costes medicos directos en los pacientes con artritis reumatoide (AR) y los factores predictores en los pacientes tratados con farmacos biologicos y sin biologicos. Metodos Se realizo un estudio transversal en una muestra incluyendo pacientes de toda la geografia nacional. Se obtuvieron datos sociodemograficos y de tratamiento. Se registro la utilizacion de recursos para los 2 anos de estudio y se hizo imputacion de costes. Se realizaron analisis de correlacion en todos los pacientes con AR y en los tratados con y sin biologicos, para estimar las diferencias entre los grupos. Los predictores de costes se analizaron mediante modelos de regresion lineal. Resultados Se incluyeron 1.095 pacientes con AR, el 26% hombres, con una edad media de 62 ± 14 anos. La media de los costes medicos directos por paciente fue de 24.291 ± 45.382 €. Excluyendo los farmacos biologicos, el coste medio por paciente fue de 3.742 ± 3.711 €. Despues de ajustar, los factores predictores de costes medicos directos para todos los pacientes con AR fueron los farmacos biologicos (p = 0,00), la comorbilidad (p = 0,00) y la edad del paciente (p = 0,01). En el grupo sin biologicos, los predictores fueron la comorbilidad (p = 0,00) y la edad del paciente (p = 0,01). En el grupo con biologicos los predictores fueron el sexo del paciente (p = 0,03) y la actividad de la enfermedad (p = 0,02). Conclusion Los datos muestran un notable impacto economico de la AR. Es importante identificar y estimar los factores asociados a mayor coste para desarrollar estrategias de reduccion de costes y aumentar la calidad de la atencion.

Objective To analyze the resource utilization in rheumatoid arthritis (RA) patients and predictive factors in and patients treated with biological drugs and biologic-naive. Methods A cross-sectional study was performed in a sample including all regions and hospitals throughout the country. Sociodemographic data, disease activity parameters and treatment data were obtained. Resource utilization for two years of study was recorded and we made costs imputation. Correlation analyzes were performed on all RA patients and those treated with biological and biological naive, to estimate the differences in resource utilization. Factors associated with increased resources utilization (costs) attending to treatment was analyzed by linear regression models. Results We included 1.095 RA patients, 26% male, mean age of 62 ± 14 years. Mean of direct medical costs per patient was €24,291 ± €45,382. Excluding biological drugs, the average cost per patient was €3742 ± €3711. After adjustment, factors associated with direct medical costs for all RA patients were biologic drugs (P = .02) and disease activity (P = .004). In the biologic-naive group, the predictor of direct medical costs was comorbidity (P Conclusion Our data show a remarkable economic impact of RA. It is important to identify and estimate the economic impact of the disease, compare data from other geographic samples and to develop improvement strategies to reduce these costs and increase the quality of care.

Introduction We have conducted a bibliometric study of the scientific publications on patient-reported outcomes in the field of rheumatology. Methods SCOPUS was the database used in this bibliometric study. We performed two searches. The main search involved selecting the documents published between 2000 and 2014 limited to top-tier journals addressing rheumatic and musculoskeletal diseases, using specific descriptors together with the operator and main descriptor "patient-reported outcomes" (PROs), and we performed a secondary search, with the following specific descriptors: "pain," "functional capacity," and "fatigue." We used bibliometric indicators for articles distribution (Price's law for the increase of scientific literature and Bradford's law for dispersion of articles). We also calculated the participation index of the different countries. Results A total of 983 original articles were published between 2000 and 2014. Our results confirmed the fulfilment of Price's law (correlation coefficient r = 0.9385 after linear adjustment). The average number of articles per Bradford Zone was 327.6. A total of 30 different journals were published. The type of growth for the descriptors "pain" ( r 2 = 0.5417 compared to r 2 = 0.4839) and "fatigue" ( r 2 = 06276 compared to r 2 = 0.5544) is exponential, whereas it is linear for the descriptor "functional capacity" ( r 2 = 0.6769 compared to r 2 = 0.3779). Discussion This study revealed significant linear growth of patient-related outcomes in global terms, as well as upward trends for most of the citation-based bibliometric indices, especially significant from 2010 to 2014. Pain and fatigue have greater growth as PRO concepts.