TY - JOUR

T1 - Rheuma-VOR study

T2 - Optimising healthcare of rheumatic diseases by multiprofessional coordinating centres

AU - Dreher, Matthias

AU - Witte, Torsten

AU - Hoeper, Kirsten

AU - Assmann, Gunter

AU - Proft, Fabian

AU - Poddubnyy, Denis

AU - Murawski, Niels

AU - Triantafyllias, Konstantinos

AU - Grodd, Marlon

AU - Graf, Erika

AU - Fichtner, Urs A.

AU - Binder, Harald

AU - Zeidler, Jan

AU - Hoeper, Juliana Rachel

AU - Callhoff, Johanna

AU - Karberg, Kirsten

AU - Trautwein, Anna

AU - Tibyampansha, Dativa

AU - Wojnowski, Leszek

AU - Schmidt, Reinhold E.

AU - Schwarting, Andreas

N1 - Funding Information: We dedicate this article to our beloved colleague Prof. Reinhold E. Schmidt, who was one of the driving forces behind the project and who sadly passed away unexpectedly two years ago. Rheuma-VOR was funded by the Innovation Fund at the Federal Joint Committee (G-BA) from 2017 to 2021. The funding has no influence on the study. Funding code: 01NVF16029. Preliminary results of the different Rheuma-VOR substudies were presented at national (DGRh) and international (EULAR) conferences. The authors would like to thank the participating rheumatological practices, the Deutsche Rheumaliga, the Rheumaliga Landesverband of the federal states, the Deutsche Vereinigung Morbus Bechterew e.V., and the participants for the excellent cooperation. Funding Information: Rheuma-VOR was funded by the Innovation Fund at the Federal Joint Committee (G-BA) from 2017 to 2021. Funding code: 01NVF16029.

PY - 2023/10/27

Y1 - 2023/10/27

N2 - Objectives: Early diagnosis of inflammatory arthritis is critical to prevent joint damage and functional incapacities. However, the discrepancy between recommendations of early diagnosis and reality is remarkable. The Rheuma-VOR study aimed to improve the time to diagnosis of patients with early arthritis by coordinating cooperation between primary care physicians, specialists and patients in Germany. Methods: This prospective non-randomised multicentre study involved 2340 primary care physicians, 72 rheumatologists, 4 university hospitals and 4 rheumatology centres in 4 German Federal States. The two coprimary endpoints (time to diagnosis and screening performance of primary care physicians) were evaluated for early versus late implementation phase. Additionally, time to diagnosis and secondary endpoints (decrease of disease activity, increase in quality of life and overall well-being, improvement of fatigue, depression, functional ability, and work ability, reduction in drug and medical costs and hospitalisation) were compared with a reference cohort of the German Rheumatism Research Centre (DRFZ) reflecting standard care. Results: A total of 7049 patients were enrolled in the coordination centres and 1537 patients were diagnosed with a rheumatic disease and consented to further participation. A follow-up consultation after 1 year was realised in 592 patients. The time to diagnosis endpoint and the secondary endpoints were met. In addition, the calculation of cost-effectiveness shows that Rheuma-VOR has a dominant cost-benefit ratio compared with standard care. Discussion: Rheuma-VOR has shown an improvement in rheumatological care, patient-reported outcome parameters and cost savings by coordinating the cooperation of primary care physicians, rheumatologists and patients, in a nationwide approach.

AB - Objectives: Early diagnosis of inflammatory arthritis is critical to prevent joint damage and functional incapacities. However, the discrepancy between recommendations of early diagnosis and reality is remarkable. The Rheuma-VOR study aimed to improve the time to diagnosis of patients with early arthritis by coordinating cooperation between primary care physicians, specialists and patients in Germany. Methods: This prospective non-randomised multicentre study involved 2340 primary care physicians, 72 rheumatologists, 4 university hospitals and 4 rheumatology centres in 4 German Federal States. The two coprimary endpoints (time to diagnosis and screening performance of primary care physicians) were evaluated for early versus late implementation phase. Additionally, time to diagnosis and secondary endpoints (decrease of disease activity, increase in quality of life and overall well-being, improvement of fatigue, depression, functional ability, and work ability, reduction in drug and medical costs and hospitalisation) were compared with a reference cohort of the German Rheumatism Research Centre (DRFZ) reflecting standard care. Results: A total of 7049 patients were enrolled in the coordination centres and 1537 patients were diagnosed with a rheumatic disease and consented to further participation. A follow-up consultation after 1 year was realised in 592 patients. The time to diagnosis endpoint and the secondary endpoints were met. In addition, the calculation of cost-effectiveness shows that Rheuma-VOR has a dominant cost-benefit ratio compared with standard care. Discussion: Rheuma-VOR has shown an improvement in rheumatological care, patient-reported outcome parameters and cost savings by coordinating the cooperation of primary care physicians, rheumatologists and patients, in a nationwide approach.

KW - arthritis, psoriatic

KW - arthritis, rheumatoid

KW - health services research

KW - spondylitis, ankylosing

UR - http://www.scopus.com/inward/record.url?scp=85175823420&partnerID=8YFLogxK

U2 - 10.1136/ard-2023-224205

DO - 10.1136/ard-2023-224205

M3 - Article

AN - SCOPUS:85175823420

VL - 83

SP - 184

EP - 193

JO - Annals of the rheumatic diseases

JF - Annals of the rheumatic diseases

SN - 0003-4967

IS - 2

M1 - ard-2023-224205

ER -