TY - JOUR

T1 - Delegation ärztlicher Leistungen an rheumatologische Fachassistenten

T2 - Effekte auf Depression und Angst bei Patienten mit rheumatoider Arthritis

AU - Hoeper, Juliana Rachel

AU - Schuch, Florian

AU - Steffens-Korbanka, Patricia

AU - Gauler, Georg

AU - Welcker, Martin

AU - Wendler, Jörg

AU - von Hinüber, Ulrich

AU - Meyer, Sara Eileen

AU - Schwarting, Andreas

AU - Zeidler, Jan

AU - Witte, Torsten

AU - Meyer-Olson, Dirk

AU - Hoeper, Kirsten

N1 - Publisher Copyright: © The Author(s) 2023.

PY - 2024/6

Y1 - 2024/6

N2 - Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.

AB - Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.

KW - Comorbidity

KW - Disease process

KW - Outpatient care

KW - Screening

KW - Team based care

UR - http://www.scopus.com/inward/record.url?scp=85169603136&partnerID=8YFLogxK

U2 - 10.1007/s00393-023-01403-9

DO - 10.1007/s00393-023-01403-9

M3 - Artikel

C2 - 37648932

AN - SCOPUS:85169603136

VL - 83

SP - 407

EP - 415

JO - Zeitschrift fur Rheumatologie

JF - Zeitschrift fur Rheumatologie

SN - 0340-1855

IS - 5

ER -