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Implementing a Treat-to-Target Approach for Rheumatoid Arthritis During the COVID-19 Pandemic: Results of a Virtual Learning Collaborative Program.
Solomon, Daniel H; Pincus, Theodore; Shadick, Nancy A; Stratton, Jacklyn; Ellrodt, Jack; Santacroce, Leah; Katz, Jeffrey N; Smolen, Josef S.
  • Solomon DH; Brigham and Women's Hospital, Boston, Massachusetts.
  • Pincus T; Rush University Medical Center, Chicago, Illinois.
  • Shadick NA; Brigham and Women's Hospital, Boston, Massachusetts.
  • Stratton J; Brigham and Women's Hospital, Boston, Massachusetts.
  • Ellrodt J; Brigham and Women's Hospital, Boston, Massachusetts.
  • Santacroce L; Brigham and Women's Hospital, Boston, Massachusetts.
  • Katz JN; Brigham and Women's Hospital, Boston, Massachusetts.
  • Smolen JS; University of Vienna, Vienna, Austria.
Arthritis Care Res (Hoboken) ; 74(4): 572-578, 2022 04.
Article in English | MEDLINE | ID: covidwho-1669343
ABSTRACT

OBJECTIVE:

A treat-to-target (TTT) approach improves outcomes in rheumatoid arthritis (RA). In prior work, we found that a learning collaborative (LC) program improved implementation of TTT. We conducted a shorter virtual LC to assess the feasibility and effectiveness of this model for quality improvement and to assess TTT during virtual visits.

METHODS:

We tested a 6-month virtual LC in ambulatory care. The LC was conducted during the 2020-2021 COVID-19 pandemic when many patient visits were conducted virtually. All LC meetings used videoconferencing and a website to share data. The LC comprised a 6-hour kickoff session and 6 monthly webinars. The LC discussed TTT in RA, its rationale, and rapid cycle improvement as a method for implementing TTT. Practices provided de-identified patient visit data. Monthly webinars reinforced topics and demonstrated data on TTT adherence. This was measured as the percentage of TTT processes completed. We compared TTT adherence between in-person visits versus virtual visits.

RESULTS:

Eighteen sites participated in the LC, representing 45 rheumatology clinicians. Sites inputted data on 1,826 patient visits, 78% of which were conducted in-person and 22% of which were held in a virtual setting. Adherence with TTT improved from a mean of 51% at baseline to 84% at month 6 (P for trend < 0.001). Each aspect of TTT also improved. Adherence with TTT during virtual visits was lower (65%) than during in-person visits (79%) (P < 0.0001).

CONCLUSION:

Implementation of TTT for RA can be improved through a relatively low-cost virtual LC. This improvement in TTT implementation was observed despite the COVID-19 pandemic, but we did observe differences in TTT adherence between in-person visits and virtual visits.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Rheumatology / Telemedicine / Education, Distance / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Arthritis Care Res (Hoboken) Journal subject: Rheumatology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Rheumatology / Telemedicine / Education, Distance / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Arthritis Care Res (Hoboken) Journal subject: Rheumatology Year: 2022 Document Type: Article