ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 138

Identification and Documentation of Secondary Osteoarthritis in Patients with Primary Inflammatory Arthritides Using a Patient MDHAQ/RAPID3 and a Physician Estimate of Joint Damage to Recognize Patient Complexity and Inform Management Decisions

Kathryn A. Gibson1, Annie Huang2, Katherine J. Bryant3 and Theodore Pincus2, 1Liverpool Hospital, Liverpool, Australia, 2Rheumatology, Rush University Medical Center, Chicago, IL, 3University of New South Wales, Sydney, Australia

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Osteoarthritis, Patient questionnaires, physician data, rheumatoid arthritis (RA) and treatment options

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Sunday, November 8, 2015

Session Title: Health Services Research Poster I: Diagnosis, Management and Treatment Strategies

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Patients with inflammatory arthritides may have secondary osteoarthritis (OA), which affects decisions concerning clinical management. For example, in one study, about 20% of patients with DAS28 scores >3.2, suggesting that therapy should be intensified according to treat-to-target, did not have intensification because of clinically important joint damage (1). We analyzed patient MDHAQ/RAPID3 scores and physician RheuMetric checklist estimates of damage (as well as overall global estimate, inflammation and distress) to identify and document secondary OA in patients with inflammatory arthritides seen in a busy clinical setting.

Methods: All patients seen at one rheumatology site complete a MDHAQ/RAPID3, and the rheumatologists complete a RheuMetric physician checklist. The MDHAQ includes scores for physical function (0-10), pain (0-10), and patient global estimate (PATGL) (0-10), compiled into a RAPID3 (0-30) score. The 1-page physician RheuMetric checklist includes a standard 0-10 visual analog scale (VAS) for physician global estimate (DOCGL), and 3 further 0-10 VAS for the levels of inflammation or reversible findings (DOCINF), damage or irreversible findings (DOCDAM), and patient distress (e.g. fibromyalgia, depression) (DOCDIS), as well as primary, secondary and tertiary rheumatic diagnoses. Patients with RA, ankylosing spondylitis, psoriatic arthritis, and inflammatory arthritis were classified as “inflammatory arthritides”, and were further classified as having or not having comorbid secondary OA. Mean MDHAQ scores and RheuMetric estimates were computed in the two groups; statistical significance was analyzed using 2-tailed t-tests with significance at p<0.05.

Results: Overall, 159 patients with inflammatory arthritides were studied, 31 with secondary OA and 128 with no secondary OA. Patients with secondary OA were older (p=0.043) and had marginally lower levels of education (p=0.267) (Table). All MDHAQ scores were higher in patients with comorbid OA, significantly for physical function (p=0.004) and pain (p=0.043). RAPID3 scores were 10.8 (moderate severity) in patients with no secondary OA and 14.1 in those with comorbid OA (p=0.026). Mean physician damage estimates were 2.9 and 4.2 in patients with no vs comorbid OA (p=0.013), and mean physician overall global estimates were 3.6 and 4.5, respectively, in the 2 groups (p=0.040). Physician estimates for inflammation and distress did not differ significantly in the 2 groups (Table).

Conclusion: Secondary OA in patients with inflammatory arthritides can be identified and documented on simple MDHAQ and RheuMetric forms in busy clinical settings. This documentation provides evidence of patient clinical complexity and may explain management decisions in certain patients which appear at variance with “treat-to-target” guidelines.

Reference: 1)Tymms K, et al. Arthritis Care Res (Hoboken). 2014;66:190-6.

Table: Patient MDHAQ scores and physician RheuMetric checklist estimates in patients with inflammatory arthritides who have and do not have secondary osteoarthritis

 

All Patients

No 2° OA

Yes 2° OA

p value

N

128

31

 

Demographic measures

Age

56.1

62.5

0.043

Education

11.2

10.4

0.267

Patient MDHAQ/RAPID3 scores

Physical Function (0-10)

1.9

3.1

0.004

Pain (0-10)

4.8

6.0

0.043

Patient Global Estimate (0-10)

4.1

5.0

0.101

RAPID3 (0-30)

10.8

14.1

0.026

Physician RheuMetric estimates

Overall Global (0-10)

3.6

4.5

0.040

Inflammation (reversible) (0-10)

2.4

2.1

0.574

Damage (irreversible) (0-10)

2.9

4.2

0.013

Distress (e.g. fibromyalgia) (0-10)

2.7

3.1

0.559


Disclosure: K. A. Gibson, None; A. Huang, None; K. J. Bryant, None; T. Pincus, Health Report Services, Inc, 4.

To cite this abstract in AMA style:

Gibson KA, Huang A, Bryant KJ, Pincus T. Identification and Documentation of Secondary Osteoarthritis in Patients with Primary Inflammatory Arthritides Using a Patient MDHAQ/RAPID3 and a Physician Estimate of Joint Damage to Recognize Patient Complexity and Inform Management Decisions [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/identification-and-documentation-of-secondary-osteoarthritis-in-patients-with-primary-inflammatory-arthritides-using-a-patient-mdhaqrapid3-and-a-physician-estimate-of-joint-damage-to-recognize-patien/. Accessed January 17, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/identification-and-documentation-of-secondary-osteoarthritis-in-patients-with-primary-inflammatory-arthritides-using-a-patient-mdhaqrapid3-and-a-physician-estimate-of-joint-damage-to-recognize-patien/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.