Rehabilitation Referral in Rheumatology: Insights From the RISE Registry

Area of Science:

• Rheumatology
• Rehabilitation Medicine
• Health Services Research

Background:

• Rheumatologic diseases like axial spondyloarthritis (axSpA), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) often benefit from rehabilitation interventions.
• Understanding current referral patterns is crucial for improving patient care and outcomes.

Purpose of the Study:

• To determine the percentage of patients with axSpA, RA, and SLE referred to rehabilitation within the Rheumatology Informatics System for Effectiveness (RISE) Registry.
• To analyze referral rates based on patient and practice characteristics.

Main Methods:

• Retrospective analysis of data from the RISE Registry, encompassing a significant portion of the US clinical rheumatology workforce.
• Inclusion criteria involved patients aged ≥18 with qualifying ICD codes for axSpA, RA, or SLE, and at least one visit in 2022.
• The primary outcome measured was the documented percentage of patients referred to physical or occupational therapy.

Main Results:

• In 2022, rehabilitation referral rates were 4.4% for axSpA, 2.7% for RA, and 2.6% for SLE.
• Lifetime referral rates were higher at 11.8% (axSpA), 9.2% (RA), and 8.7% (SLE).
• A majority of practices (52-61%) referred less than 1% of their eligible patients to rehabilitation in 2022.

Conclusions:

• Rehabilitation referral rates from rheumatology practices are notably low across axSpA, RA, and SLE patient populations.
• Significant variation exists in referral practices among different rheumatology practices.
• Current treatment guideline recommendations for rehabilitation appear to have minimal influence on actual referral behavior.