1. Relevance and feasibility of a systematic screening of multimorbidities in patients with chronic inflammatory rheumatic diseases
- Author
-
Jacques Morel, François Roubille, Bernard Combe, Jean Bousquet, Jean-David Cohen, Mégane Beurai-Weber, Pierre Fesler, Marie-Christine Picot, Audrey Jaussent, A. Tubery, Claire Daïen, Guilhem du Cailar, Institut de Génétique Moléculaire de Montpellier (IGMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, MORNET, Dominique, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CIC Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche Virologie et Immunologie Moléculaires (VIM), Institut National de la Recherche Agronomique (INRA), Institut de Génétique Moléculaire de Montpellier ( IGMM ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), UR 0892 VIM Unité de recherche Virologie et Immunologie Moléculaires, Institut National de la Recherche Agronomique ( INRA ), and Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie
- Subjects
Lung Diseases ,Male ,[SDV]Life Sciences [q-bio] ,Disease ,Arthritis, Rheumatoid ,0302 clinical medicine ,Risk Factors ,Cancer screening ,Lupus Erythematosus, Systemic ,Mass Screening ,030212 general & internal medicine ,Connective Tissue Diseases ,skin and connective tissue diseases ,EULAR point to consider ,[SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,medicine.diagnostic_test ,Vaccination ,Sleep apnea ,Middle Aged ,3. Good health ,[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,Rheumatoid arthritis ,Psoriatic arthritis ,Screening ,Female ,Spirometry ,Vasculitis ,musculoskeletal diseases ,medicine.medical_specialty ,education ,Risk Assessment ,03 medical and health sciences ,Rheumatology ,Internal medicine ,Diabetes mellitus ,Rheumatic Diseases ,Spondylarthritis ,Spondyloarthritis ,medicine ,Humans ,Aged ,030203 arthritis & rheumatology ,[ SDV ] Life Sciences [q-bio] ,business.industry ,Multimorbidity ,medicine.disease ,Cardiovascular disease risk ,Polymyositis ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Lung disease ,Chronic Disease ,Feasibility Studies ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Dyslipidemia - Abstract
International audience; Objectives: EULAR recently proposed to screen multimorbidities in chronic inflammatory rheumatic diseases. The aims of the study were to define the most common multimorbidities in chronic inflammatory rheumatic diseases, compare the screening approach performed in the clinic with the recent EULAR recommendations, validate the points to consider for the systematic standardized multimorbidity screening proposed by EULAR and assess feasibility of such a screening in a daily clinic.Methods: Data were collected prospectively during a 1-day multimorbidity clinic. Diabetes, hypertension, CVD damage, chronic respiratory diseases, osteoporosis and preventive measures were assessed. The comparison with EULAR points to consider was performed retrospectively.Results: We included 200 consecutive patients (157 with rheumatoid arthritis, 37 spondyloarthritis, and 6 connective tissue diseases or vasculitis). The most common multimorbidities already diagnosed in our patients were hypertension (26%) and diabetes (7.5%). Screening showed that 61.5% (CI95%: 54.6%-67.9%) patients presented at least one undiagnosed or uncontrolled diseases: diabetes (6%), hypertension (20.6%), dyslipidemia (16.1%) valvulopathies (16.8%), peripheral artery disease (4.5%); carotid stenosis (6.5%) and aortic aneurysm (5.5%). Overall, 39.9% patients had incomplete cancer screening and 52.8% incomplete vaccine schedule. Undiagnosed pulmonary obstruction and risk of sleep apnea were suspected in 15.5% and 40.1% patients, respectively.Conclusion: This study underlines the relevance of a systematic screening of multimorbidities in chronic inflammatory rheumatic diseases and its feasibility in a 1-day clinic. Spirometry and sleep apnea screening should be added to EULAR points to consider. The long-term impact of such screening needs to be evaluated.
- Published
- 2018