AB1240 Effect of a multidisciplinary approach in the pharmacological therapy process for patients with rheumatoid arthritis in a specialised rheumatology centre
Authors: D. Buitrago-Garcia, L. Villarreal-Peralta, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA-9 is an inflammatory autoimmune disease with a prevalence of 0.2% to 1%.<sup>1</sup> Although the advances in pharmacological treatments offered to manage the disease have achieved many goals, the disappearance of symptoms and disabilities are accomplished by a small proportion of patients with RA.<sup>2</sup> However, patients need a follow up where a multidisciplinary team care programs for patients with RA take into consideration not only the disease activity but psychosocial, adherence and other aspects that conventional care does not take into account, showing a positive effect in all life aspects of a patient with RA(.<sup>2, 3</sup> <h3>Objectives</h3> To evaluate the effectiveness regarding, treatment, safety and rehabilitation in patients with a complex disease activity through a multidisciplinary care management. <h3>Methods</h3> Once a rheumatologist identified a patient with RA with indication to begin biological therapy or switching from one biological to another, a checklist and an evaluation was performed, then the patient was presented in a multidisciplinary team meeting where a rheumatologist, pharmaceutical chemist, psychologist, physiatrist and a nurse assessed the particular case of the patient. Additionally, an ultrasound was performed in every patient in order to evaluate disease activity. Based on the patient's disease activity, adherence to treatment, psychosocial and economic factors the pharmacological therapy and management of the patient was prescribed. <h3>Results</h3> During 18 months 551 patients were evaluated by a multidisciplinary team, 90% to define the pharmacological therapy, and 10% for biologic switching. Mean DAS28 of patients was 3.79±1.37, once the patients were evaluated the choices made by the team were: 60% continued in follow-up receiving conventional DMARDs therapy because ultrasound didn't show any disease activity; finally biological therapy was initiated in 21% and switching among biologicals was made in 11%, conventional therapy was adjusted in 5% of patients, and discontinuation of therapy due to non-adherence of patients or other reasons was ordered in 3%. <h3>Conclusions</h3> As other studies have shown, a multidisciplinary assessment of the patient with RA from different viewpoints allows taking into consideration aspects that are not linked only to the pharmacological therapy but to other aspects in a patient's life. Also we avoided high costs therapies for the management of rheumatoid arthritis, therefore we contribute not only to the health outcomes of patients but the health economic aspects in the management of RA. <h3>References</h3> [1] Alamanos Y, et al. Incidence and prevalence of rheumatoid arthritis, based on the 1987 American College of Rheumatology criteria: a systematic review. Seminars in arthritis and rheumatism. 2006;36(3):182–8. [2] Vliet Vlieland TP, et al. Efficacy of multidisciplinary team care programs in rheumatoid arthritis. Seminars in arthritis and rheumatism. 1997;27(2):110–22. [3] Arentz-Hansen H, et al. NIPH Systematic Reviews: Executive Summaries. Effect of Multidisciplinary, Team-Based Rehabilitation, Including Education, in Rheumatoid Arthritis. Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH), 2012. <h3>Disclosure of Interest</h3> None declared