Objective: To describe sustainability of low disease activity levels in patients with rheumatoid arthritis (RA) who were followed-up in a specialized center based on a healthcare model maintaining adherence to appointments and treatment.
Material and methods: As part of a comprehensive RA healthcare model, services related to care like rheumatology, physiatry, physiotherapy, occupational therapy, nutrition, and psychology can be found in the specialized center. Patients with RA are followed-up at least six times a year to ensure retention in care model and adherence to the treatment. Using this approach, a cohort of RA patients were followed-up during 2018. Demographical and clinical data were extracted retrospectively from the electronic health records. The association between clinical and demographic variables was studied by means of the Chi-square test and analyzed using the McNemar test for changes in disease activity levels.
Results: 2,239 RA patients were followed-up, 82.76% were women. The average disease duration was eight years (IQR: 3-18 years). During the follow-up year, 91.62% of patients with conventional therapy had at least six rheumatology appointments, while for those who received biological therapy 81.51%. For the ones treated with biological therapy, there were no significant changes for each level of disease activity during study period; nevertheless, in patients who received conventional therapy there was a significant increase of patients in remission (p-value = 0.004).
Conclusions: The results evidence that the model used guarantees high levels of adherence for medical appointments and keeps remission levels for RA under control.