Real-World Adherence to Systemic Sclerosis Quality Indicators: A Single-Center Quality of Care Study

Area of Science:

• Rheumatology
• Clinical Quality Improvement
• Systemic Sclerosis Research

Background:

• Systemic sclerosis (SSc) significantly impacts patient morbidity and mortality.
• Internationally recognized quality indicators (QIs) exist to standardize SSc care.
• Real-world adherence to SSc QIs requires further characterization.

Purpose of the Study:

• To evaluate adherence to baseline and longitudinal SSc QIs.
• To identify predictors of QI adherence in a specialized SSc clinic.

Main Methods:

• Retrospective cohort study of 66 SSc patients (2016-2024).
• Assessment of adherence to screening (ILD, PH), monitoring (PFT, echo, skin), and treatment QIs.
• Multivariable logistic regression to identify adherence predictors.

Main Results:

• High adherence to baseline screening (HRCT 86%, Echo 84%) and digital ulcer treatment (100%).
• Suboptimal longitudinal adherence: PFT (35%), follow-up echo (36%), skin score (19%), PT referral (37%).
• Predictors of lower adherence included older age, longer disease duration, diffuse SSc, and pulmonary hypertension.

Conclusions:

• Despite good baseline adherence, significant gaps exist in longitudinal SSc care.
• Areas for improvement include ongoing monitoring, documentation, and rehabilitation.
• Identifying predictors aids targeted quality improvement initiatives in SSc.