SAT0607-HPR MULTIDISCIPLINARY CARE CLINIC FOR PATIENTS WITH IMMUNITY MEDIATED INFLAMMATORY DISEASES. FIRST YEAR OF COORDINATED MANAGEMENT
Authors: C. Gonzalez, L. A. Menchén Viso, O. Baniandrés Rodríguez, I. Marín-Jiménez, J. C. Nieto, I. Monteagudo, A. Ais Larisgoitia, E. Chamorro de Vega, E. Lobato Matilla, R. Romero Jiménez, A. Herranz Alonso, C. Lobo Rodríguez, M. P. Simón Moreno, J. M. Alvaro-Gracia, S. García de San José
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with immunity mediated inflammatory diseases (IMID) often have clinical manifestations and comorbidity in the field of various medical specialties. A center has been created in our hospital for the comprehensive care of patients with IMID who are being treated with biological therapies (BT) or targeted synthetic molecules (TSM). It is an innovative healthcare model, that incorporate patients into its governance. Physicians, pharmacists and advanced practice nurses (APN), collaborates in consultation or in the day hospital (DH). Objectives: To analyze the activity developed during the first year of operation of the center, with special attention to effectiveness, efficiency, interdisciplinary relationships and patient satisfaction. Methods: Observational analysis with indicators of management and monitoring of patients, care activity, effectiveness, adverse effects, resource consumption and patient satisfaction using the hospital’s own information systems. Results: Center staff during 2019: two admission assistants, one nursing assistant, six nurses, seven part-time doctors and three pharmacists. 1,490 patients were included: 694 (46.6%) Rheumatology (Rheu), 585 (39.3%) Digestive (Dig) and 211 (14.1%) Dermatology (Der) generated 11,363 medical consultations, 14,850 APN consultations and 3,920 treatment sessions in the DH. IV treatment 529/1490 (35.5%) patients (45.0% Reu, 53.9% Dig, 1.1% Der). Patients with rheumatic diseases: rheumatoid arthritis: 339/694, 48.8%; Spondyloarthritis: 226/694, 32.6%; psoriatic arthritis: 117/694, 16.9%; and juvenile idiopathic arthritis: 12/694, 1.7%. 217/1490 (14.6%) patients needed multidisciplinary consultations. Table 1. shows the most relevant indicators and table 2 shows the patient satisfaction survey for 2019. Table 1. relevant indicators RHEU DIG DER On demand consultations 2019 % 21.0% 34.2% 14.3% Teleconsultations 2019 % 17.8% 41.9% 0.0% BT, TSM tapering. % 2019 31.9% 0.2% 45,5% 2018 18.9% 0.2% 13.4% BT, TSM intensification. % 2019 5.8% 35.2% 0.5% 2018 2.6% 36.5% 0.5% Biosimilars % 2019 43.1% 48.5% 15.9% 2018 30.4% 4.0% 12.1% Adherence&gt;90% 2019 % 89.4% 91.7% 86.4% Remission 2019 % 47.8% 67.3% 78.5% hospital admission, any cause pat-years 2019 1.4 1.7 0.1 2018 1.5 1.5 0.04 emergency admission, any cause pat-years 2019 2.1 2.1 1.6 2018 2.1 2.0 1.5 Table 2. patient satisfaction survey Categoría Mean and (DS) 1-5 General aspects of the center 4.3 (0.9) Physicians 4.5 (1.1) DH and APN 4.5 (1.2) Pharmacy 4.6 (0.9) Health proffesional coordinaton 4.4 (0.9) Hospital global satisfaction 4.3 (0.8) Conclusion: From previous situation there is an increase in interdisciplinary consultations and HD activity maintenance without an increase in human resources. Efficiency (tapering, biosimilars) and patient and staff satisfaction have improved. However, no improvement in adverse effects has been observed, which is an area of improvement. Effectiveness is good, waiting to compare with the previous year. Nutrition and preventive medicine consultations has not been evaluated because have been recently established. Other indicators are being analyzed at the end of the submission deadline. The impact of this pioneering management model, with a holistic approach and incorporating patients into its governance, is difficult to measure until its implementation is completed. Uveitis and psychology consultations and patient school starting in 2020 will improve the quality of IMID patient care, as well as their satisfaction and that of their relatives. Disclosure of Interests: Carlos Gonzalez Consultant of: Gilead, Janssen, Novartis,, Speakers bureau: Abbvie, Celgene, Gilead, Janssen, Novartis, Pfizer, Roche, Luis Alberto Menchén Viso Grant/research support from: Abbvie, Janssen, MSD, Takeda, Consultant of: Abbvie, Janssen, Takeda, MSD, Medtronic, Tillotts, Pfizer, Dr. Falk Pharma, Speakers bureau: Abbvie, Janssen, Takeda, MSD, General Electric, Tillotts, Pfizer, Ferring, General Electric, Fresenius, Ofelia Baniandrés Rodríguez: None declared, Ignacio Marín-Jiménez Consultant of: AbbVie,Chiesi,FAES Farma,Falk-Pharma,Ferring,Gebro Pharma, Hospira,Janssen,MSD,Otsuka Pharmaceutical,Pfizer,Shire,Takeda,Tillots and UCB Pharma, Speakers bureau: AbbVie,Chiesi,FAES Farma,FalkPharma,Ferring,Gebro Pharma,Hospira,Janssen,MSD,Otsuka Pharmaceutical,Pfizer,Shire,Takeda,Tillots and UCB Pharma, Juan Carlos Nieto Speakers bureau: Pfizer, Abbvie, MSD, Novartis, Janssen, Lilly, Nordic Pharma, BMS, Gebro, FAES Farma, Roche, Sanofi, Indalecio Monteagudo: None declared, Arantza Ais Larisgoitia: None declared, Esther Chamorro de Vega: None declared, Elena Lobato Matilla: None declared, Rosa Romero Jiménez: None declared, Ana Herranz Alonso: None declared, Carmen Lobo Rodríguez: None declared, María Prado Simón Moreno: None declared, Jose-Maria Alvaro-Gracia Grant/research support from: Abbvie, Elli-Lilly, MSD, Novartis, Pfizer, Consultant of: Abbvie, BMS, Janssen-Cilag, Elli-Lilly, MSD, Novartis, Pfizer, Sanofi, Tigenix, Roche, UCB, Paid instructor for: Elli-Lilly, Pfizer, Roche, Speakers bureau: Abbvie, BMS, Janssen-Cilag, Elli-Lilly, Gedeon Richter, MSD, Novartis, Pfizer, Sanofi, Tigenix, Roche, UCB, Sonia García de San José: None declared