SAT0692 DEALING WITH COMORBIDITIES IN RHEUMATOID ARTHRITIS WITH MEDICAL ASSISTANTS. THE PATIENTS’ OPINION ON ASSESSMENT AND EDUCATION BY MEDICAL ASSISTANTS DURING ROUTINE CLINICAL PRACTICE
Authors: Stefan Kleinert, Praxedis Rapp, Monika Ronneberger, Joerg Wendler, Florian Schuch
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> In 2006 the curriculum for rheumatology health professionals of the Academy of the German Association of Rheumatologists (DGRh) was developed. [1]. Since then more than 1400 health professionals (medical assistants [medizinische Fachangestellte] and nurses) were trained and are currently playing an increasing role in rheumatology practices in Germany. <h3>Objectives</h3> To evaluate the patients' opinion on the assessment by medical assistants in general and regarding assessment and education on cardiovascular risk and vaccination. <h3>Methods</h3> Patients with rheumatoid arthritis were interviewed by a medical assistant in a rheumatology practice that is part of the public health care system with five rheumatologists in Erlangen, Germany A semi-standardized interview assessed disease activity, pain, medication, general health, and side effects of medication. A part of the patients was also assessed and educated regarding cardiovascular risk or vaccinations. Thereafter they were examined by the rheumatologist and finally asked to complete a questionnaire regarding their visit. The questions were numerical scales ranging from 0 [very good, very satisfied] to 10 [very poor/inadequate]. <h3>Results</h3> 293 Patients (mean age 61.3 ± 13.5 years, mean DAS28 2.8 ± 0.9, mean FFbH 76,4 ± 20.8) were documented between August and December 2018. 212 completed the general questionnaire, 34 regarding a structured cardiovascular assessment and education, and 18 regarding a structured assessment of vaccinations. Table 1 shows patients answers between 0 [very good, very satisfied] to 10 [very poor/inadequate]. Overall rating was excellent with a mean score of 1.0 (SD 1.5). The rating was only slightly different, if patients were assessed by medical assistants for the first time (n=111; mean score 1.2, SD 1.5), between the 2<sup>nd</sup> to 4<sup>th</sup> time (n=82; mean score 1.0, SD 1.3) or the 5<sup>th</sup> time or more (n=19; mean score 0.6, SD 0.6) <h3>Conclusion</h3> The semi-standardized assessment of patients with rheumatoid arthritis by medical assistants, the cardiovascular risk assessment and education, and the assessment and information on vaccination was very well accepted and appreciated by patients. Currently, there is no reimbursement by the German health care system. <h3>Reference</h3> [1] Schuch F, Kern P, Kreher G, Kruger K, Wendler J, Fiehn C. [Curriculum for "Rheumatology health professionals DGRh-BDRh" as a way of qualification for clinical nursing specialists : Concept and results of an evaluation]. Z Rheumatol. 2011 Oct; 70(8):670-677. <h3>Acknowledgement</h3> Statistical analysis was carried out by Dr. M. Englbrecht, Healthcare Data Scientist, Eckental, Germany. <h3>Disclosure of Interests</h3> Stefan Kleinert Grant/research support from: Novartis, Consultant for: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Speakers bureau: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Praxedis Rapp: None declared, Monika Ronneberger Consultant for: Celgene, Novartis, Paid instructor for: Abbvie, Bristol Myers Squibb, Novartis, Speakers bureau: Celgene, Novartis, Bristol Myers Squibb, Pfizer, Joerg Wendler Consultant for: Roche Pharma AG, AbbVie, Jannssen Cilag, Novartis, Speakers bureau: Roche Pharma AG, AbbVie, Jannssen Cilag, Novartis, Florian Schuch Consultant for: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie, Novartis, Speakers bureau: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie