دورية أكاديمية
Development and Evaluation of a Clinic for Elderly Patients with Rheumatoid Arthritis and Multimorbidity: A Pilot Study.
| العنوان: | Development and Evaluation of a Clinic for Elderly Patients with Rheumatoid Arthritis and Multimorbidity: A Pilot Study. |
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| المؤلفون: | van Moerbeke A; Maastricht University Medical Center, Maastricht, the Netherlands., Magdelijns F; Maastricht University Medical Center, Maastricht, the Netherlands., Cleutjens F; Expertisecentrum voor Chronisch Orgaanfalen Expertisecentrum voor Chronisch Orgaanfalen (CIRO), Horn, the Netherlands., Boonen A; Maastricht University Medical Center, Maastricht, the Netherlands., van Onna M; Maastricht University Medical Center, Maastricht, the Netherlands. |
| المصدر: | ACR open rheumatology [ACR Open Rheumatol] 2021 Jan; Vol. 3 (1), pp. 34-40. Date of Electronic Publication: 2020 Dec 31. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: John Wiley & Sons Inc Country of Publication: United States NLM ID: 101740025 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2578-5745 (Electronic) Linking ISSN: 25785745 NLM ISO Abbreviation: ACR Open Rheumatol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Hoboken, New Jersey : John Wiley & Sons Inc., [2019]- |
| مستخلص: | Objective: Integrating patient's and physician's goals, especially in elderly patients with multimorbidity, might ultimately improve care. Efforts to develop such care innovations in patients with rheumatoid arthritis (RA) are lacking. The objective of our study was to develop and to pilot test a clinic for elderly patients with RA and multimorbidity. Methods: First, a referral strategy for and the content of an Elderly Multimorbidity Clinic (EMC) was developed. Next, the EMC was implemented, and it primarily focused on the personal goals of patients and medication review. The EMC was evaluated in a quantitative-qualitative approach. Results: Referral considered useful by the rheumatologist was chosen as the referral criterion. A rheumatologist and internist-geriatrician provided care to referred patients (≥ 55 years) at the EMC during three visits over 1 year. Twenty patients with RA participated in the pilot study (mean age 76.8±7.7 years; 30% male). Only 12 (60%) patients attended the first follow-up consultation, and three (15%) attended the second follow-up consultation. During any follow-up visit, 9/12 (75%) patients achieved one or more goals. Examples of accomplished goals were reduction of medication and improvement of mobility. In 19/20 (95%) patients, medication was remediated (stop medication for 13 patients; start medication for five patients) during the first visit. After 1 year, medication was changed back in 10 patients. Rheumatologists revealed uncertainty about meaningful referral, and patients and rheumatologists mentioned high (caregiver) burden because of extra visits as reasons for not attending follow-up. Patients were satisfied with the care provided. Conclusion: This goal-directed EMC led to the accomplishment of at least one goal in 75% of patients. Sustained benefits could not be demonstrated because of low follow-up. (© 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.) |
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| معلومات مُعتمدة: | Pfizer Foundation; Academic incentive Maastricht Universitair Medisch Centrum |
| تواريخ الأحداث: | Date Created: 20201231 Latest Revision: 20221005 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC7811693 |
| DOI: | 10.1002/acr2.11213 |
| PMID: | 33381919 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2578-5745 |
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| DOI: | 10.1002/acr2.11213 |