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<div class="csl-entry">Studenic, P., Schwab, N., Stamm, T., Zauner, G., Urach, C., Zechmeister, M., Nakhost Lotfi, N., Popper, N., & Radner, H. (2024). <i>Socio-economic modeling of pathways in rheumatoid arthritis patients of stable disease activity</i> [Poster Presentation]. ÖGR Jahrestagung 2024, Wien, Austria. http://hdl.handle.net/20.500.12708/226765</div>
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dc.identifier.uri
http://hdl.handle.net/20.500.12708/226765
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dc.description.abstract
Aim: Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with poor outcomes and high socio-economic costs due to higher needs in healthcare utilization (HCU). The overall aim of treating Rheumatoid Arthritis (RA) patients is achievement of low disease activity (LDA) or even better remission (REM) as they are associated with achievement of better disease related longterm outcomes. Ideally, after successful achievement of such targets, patients would stay in stable phases of well controlled disease activity. The socio-economic value of stable phases and the amount of HCU needed within such phases is unclear yet. The aim of this study was therefore to compare patients within stable phases of disease trajectory (stable patients) to those without (unstable patients) regarding socio-economic variables.
Methods: We extracted stable phases of patients with RA that have been documented in a monocentric prospective registry. Patients were considered as “stable” if no changes or dose escalation in disease modifying antirheumatic drugs (DMARDs) or major increases (<=2cm) in disease activity as assessed by the Evaluator Global Assessment of disease activity (EGA) took place. Extracted data of stable patients were matched with reimbursement data of deceased patients via probabilistic matching (using sex, year of birth and year and month of death). Following data on HCU were used for analyses: number of doctor visits [general practitioners GP and specialist], number and length of hospital stays (inpatient only). HCU was compared between stable and unstable patients, calculating the average value (e.g. the average number of doctor visits) per 100 days. We further performed a multilinear regression analysis to identify parameters statistically associated with HCU using the following variables: stable phase (Y/N), female (Y/N) Age (<70/>=70 years).
Results: We identified 259 patients in stable disease phases and 132 patients in unstable phases (patient groups overlap partially), which could be further matched to reimbursement data. Both groups have a similar age and disease duration, but patients in stable phases have more females and lower disease activity values (see also Table 1). In general, however, stable patients had higher HCU compared to unstable patients: a significantly higher number of GP visits/100 days (1.34 stable vs 1.19 unstable patients) and a higher number of specialist visits/100 days (0.86 stable vs. 0.55 unstable patients). The number of hospital days/100 days was comparatively low for both groups (0.38 stable vs 0.25 unstable patients) with a low length of stay (0.06 days/100 days for stable vs. 0.04 days/100 days for unstable patients; if we only consider patients that actually spent a night in inpatient care, this is 0.25 days/100 days for stable vs. 0.21 days/100 days for unstable patients). In Multivariate regression modes we could find a significant association of age with all HCU variables, namely significantly lower HCU with younger age. Female sex was not significantly associated with HCU.
Conclusions: In this study we could show that patients considered in a stable phase of the disease course overall had lower disease activity values and higher HCU within first year of stable phase. Self-management, supported by digital Apps such as RheumaBuddy (https://www.healthbuddy.eu/rheumabuddy-coach) could be beneficial in this patient group as it could help patients to take control of their disease despite medical treatment, thus, improving quality of life without further HCU.
en
dc.language.iso
en
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dc.subject
Rheumatoid Arthritis
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dc.subject
Pathways
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dc.subject
Modeling
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dc.title
Socio-economic modeling of pathways in rheumatoid arthritis patients of stable disease activity
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dc.type
Presentation
en
dc.type
Vortrag
de
dc.contributor.affiliation
Karolinska Institutet, Sweden
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dc.contributor.affiliation
Medical University of Vienna, Austria
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dc.contributor.affiliation
Medical University of Vienna, Austria
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dc.contributor.affiliation
Brigham and Women's Hospital, United States of America (the)
