Finding consensus on meaningful reporting measures for rheumatoid arthritis: Results from a modified Delphi study

Area of Science:

• Rheumatology
• Pharmacy Practice
• Health Outcomes Research

Background:

• Specialty pharmacies collect extensive data but infrequently use it for performance evaluation or clinical decisions.
• Standardized measures are crucial for benchmarking, performance-based contracts, and optimizing high-cost drug use.
• Improving patient care and medication management requires better utilization of collected data.

Purpose of the Study:

• To achieve consensus among specialty pharmacy stakeholders on essential and practical measures for managing rheumatoid arthritis (RA) patients.
• To identify key performance indicators for specialty pharmacies involved in RA care.

Main Methods:

• A modified Delphi study involved 25 sites and expert panelists from diverse RA backgrounds across three survey rounds.
• An environmental scan identified initial measures, followed by Likert scale ratings for importance and usability.
• Feasibility was assessed by specialty pharmacy panelists, with final categorization into core, reach, or neither.

Main Results:

• 118 of 315 recruited panelists participated, with high response rates across rounds (73-83%).
• Consensus was reached on 13 important and usable measures.
• Seven core measures (adherence, adverse effects, response to therapy, discontinuation, switching, TB/Hep B screening) and six reach measures were identified.

Conclusions:

• A consensus was achieved on 13 key measures for specialty pharmacies managing RA patients.
• Most identified measures were considered moderately to very feasible by specialty pharmacists.
• These standardized measures can enhance specialty pharmacy performance and patient outcomes in RA.