Prävalenz, Komorbidität und interdisziplinäre Versorgung der Rheumatoiden Arthritis – Versicherungsdaten zur ambulanten und stationären Versorgung in Baden-Württemberg

TY - JOUR

T1 - Prävalenz, Komorbidität und interdisziplinäre Versorgung der Rheumatoiden Arthritis – Versicherungsdaten zur ambulanten und stationären Versorgung in Baden-Württemberg

AU - Strahl, A

AU - Schneider, O

AU - Frankenhauser-Mannuß, J

AU - Knapstein, S

AU - Hermann, C

AU - Lembeck, B

AU - Lorenz, H-M

AU - Rüther, W

AU - Flechtenmacher, J

PY - 2018/3

Y1 - 2018/3

N2 - BACKGROUND: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population.OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services.MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013.RESULTS: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group.CONCLUSION: RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.

AB - BACKGROUND: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population.OBJECTIVE: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services.MATERIAL AND METHODS: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013.RESULTS: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group.CONCLUSION: RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.

KW - English Abstract

KW - Journal Article

U2 - 10.1007/s00393-017-0381-6

DO - 10.1007/s00393-017-0381-6

M3 - SCORING: Zeitschriftenaufsatz

C2 - 28929232

VL - 77

SP - 113

EP - 126

JO - Z RHEUMATOL

JF - Z RHEUMATOL

SN - 0340-1855

IS - 2

ER -