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[Do patients with active chronic polyarthritis get "basic therapy"?].

H H Raspe1, A Wasmus

  • 1Abteilung Rheumatologie, Medizinische Hochschule Hannover.

Sozial- Und Praventivmedizin
|January 1, 1988
PubMed
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Evaluating antirheumatic therapy revealed that 82% of rheumatoid arthritis patients with active disease were undertreated with remission-inducing drugs (RIDs). This highlights a significant gap in optimal rheumatoid arthritis care.

Area of Science:

  • Rheumatology
  • Health Services Research
  • Medical Care Evaluation

Context:

  • Assessing the adequacy of individual therapeutic regimens is crucial for process evaluation in medical care.
  • Rheumatoid arthritis (rA) management often involves remission-inducing drugs (RIDs) like Chloroquine and Gold.
  • Evaluating the current treatment of rA patients with RIDs is essential for improving patient outcomes.

Purpose:

  • To develop and apply a five-step procedure for evaluating the adequacy of individual antirheumatic therapy.
  • To assess the current treatment of rheumatoid arthritis patients with remission-inducing drugs.
  • To determine the gap between formal treatment guidelines and actual clinical practice for rA patients.

Summary:

  • A five-step evaluation procedure was applied to 75 rheumatoid arthritis patients regarding their treatment with remission-inducing drugs (RIDs).

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  • Only 18% of patients with active disease requiring treatment were receiving RIDs, indicating potential undertreatment in 82% of cases.
  • The formal evaluation showed a sensitivity of 0.70 and specificity of 0.80 when compared to clinical judgments, with 73% overall agreement.

    • Impact:

    • Identifies a significant underutilization of remission-inducing drugs in rheumatoid arthritis patients.
    • Highlights potential deficiencies in the process of care for rheumatoid arthritis.
    • Provides a framework for evaluating therapeutic regimen adequacy in rheumatology practice.