[Current patient care of giant cell arteritis in Rhineland-Palatinate]
Christian von Kiel1, Matthias Dreher1,2, Konstantinos Triantafyllias3
1Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
Insights
Giant cell arteritis (GCA) diagnosis and treatment in Rhineland-Palatinate are primarily managed by general practitioners. Delays in diagnosis and rheumatological co-treatment highlight a need for improved care pathways and training.
Area of Science:
- Rheumatology
- Internal Medicine
- Vasculitis Research
Background:
- Giant cell arteritis (GCA) is a common vasculitis in older adults.
- Prompt diagnosis and treatment are crucial to prevent irreversible vision loss.
- Current data on outpatient GCA care in Rhineland-Palatinate are lacking.
Purpose of the Study:
- To assess the current outpatient health care situation for GCA patients in Rhineland-Palatinate.
- To understand disease frequency, management, and comorbidities.
- To identify areas for improvement in GCA patient care.
Main Methods:
- A questionnaire was distributed to specialists (neurologists, rheumatologists, ophthalmologists, GPs) in the ADAPTHERA network.
- Data on disease frequency, activity, drug therapy, and comorbidities were collected.
- Information was supplemented with ambulatory coding data from the Association of Statutory Health Insurance Physicians.
Main Results:
- 272 GCA patients were identified in Rhineland-Palatinate.
- Average time to diagnosis was 3.6 months.
- Glucocorticoids, methotrexate, aspirin (ASA), and azathioprine were common therapies. Cardiovascular diseases, chronic pain, depression, osteoporosis, and diabetes were frequent comorbidities.
Conclusions:
- General practitioners predominantly manage GCA patients.
- Challenges exist in long-term therapy and timely rheumatological co-treatment.
- Primary care physicians desire further rheumatological training and advocate for a "vasculitis fast-track" system.
Background:
Giant cell arteritis (GCA) is one of the most common forms of inflammatory vasculitis in older patients. Because of possible irreversible vision deterioration, a fastest possible diagnosis and therapy is of absolute importance. To date, there are still no reliable data to obtain an initial assessment of the outpatient health care situation of patients diagnosed with GCA in Rhineland-Palatinate.
Methods:
The specialists (neurologists, rheumatologists, ophthalmologists and general practitioners) participating in the statewide rheumatology network ADAPTHERA were questioned with the help of a questionnaire regarding disease frequency, activity, drug therapy and possible comorbidities. In addition, the collected data were compared and supplemented by the ambulatory coding of the Association of Statutory Health Insurance Physicians in Rhineland-Palatinate.
Results:
Based on the information provided by general practitioners, 272 GCA patients were treated in Rhineland-Palatinate during the survey period. The average duration of the disease until diagnosis was 3.6 (SD ± 4.8) months. Drug therapy in the form of glucocorticoids was in first place followed by methotrexate, acetylsalicylic acid (ASA) and azathioprine. Cardiovascular diseases, chronic pain syndromes, depression, osteoporosis and diabetes mellitus were also described as comorbidities.
Conclusion:
The majority of patients with GCA are being cared for by general practitioners (GP). Long-term therapy and timely rheumatological co-treatment seem to be problematic. The primary care providers expressed their wishes for rheumatological training and further education measures. In terms of diagnosis and treatment, there is a demand to implement a "vasculitis fast-track" module.
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