Screening in Inflammatory Rheumatic Diseases Pays Off

TOPLINE:
Patients with inflammatory rheumatic diseases who are systematically screened for common chronic and preventable diseases are more likely to receive preventive medications and less likely to have emergency admissions and hospitalisations.
METHODOLOGY:
Investigators in France conducted a cohort study comparing patients with inflammatory rheumatic diseases (rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis) by participation in a systematic screening programme.
The programme involved clinical assessments, laboratory tests, imaging studies, and screenings pertaining to common chronic and preventable diseases (eg, cardiovascular disease, osteoporosis, cancer, and infectious diseases).
They performed a multivariate analysis (1144 patients) and a propensity score–matched analysis (562 patients).
The main outcome was a composite score for dispensation of preventive drugs (vaccines, lipid-lowering drugs, antiosteoporotic drugs, and antiplatelet drugs) during the year after the index date.
TAKEAWAY:
In the multivariate analysis, compared with non-participating peers, patients participating in the programme were:More likely to receive preventive drugs (adjusted odds ratio, 1.6; P < .01) and have a cardiologist and/or pulmonologist consultation (1.9; P < .01).Less likely to have an emergency admission or unscheduled hospitalisation for fracture, a cardiovascular event, or infection (0.4; P < .01).
More likely to receive preventive drugs (adjusted odds ratio, 1.6; P < .01) and have a cardiologist and/or pulmonologist consultation (1.9; P < .01).
Less likely to have an emergency admission or unscheduled hospitalisation for fracture, a cardiovascular event, or infection (0.4; P < .01).
In the propensity score–matched analysis, compared with non-participating peers, patients participating in the programme were:More likely to receive preventive drugs (odds ratio, 1.6; P = .02) and have a cardiologist and/or pulmonologist consultation (2.2; P = .002).Less likely to have an emergency admission or unscheduled hospitalisation for fracture, a cardiovascular event, or infection (0.4; P = .003).
More likely to receive preventive drugs (odds ratio, 1.6; P = .02) and have a cardiologist and/or pulmonologist consultation (2.2; P = .002).
Less likely to have an emergency admission or unscheduled hospitalisation for fracture, a cardiovascular event, or infection (0.4; P = .003).
Programme participation did not significantly affect rates of cardiovascular events or fractures.
IN PRACTICE:
“Although EULAR highlights the need for proactive screening and prevention measures, the effectiveness of systematic screening programmes for multimorbidity in patients with [inflammatory rheumatic disease] remains inadequately evaluated,” the authors wrote. The improvements seen in the study “confirm…the positive impact of such a programme on the application of the given recommendations” and “justify…time and resource allocation for such screening initiatives,” they concluded.
SOURCE:
The study was led by Claire Immediato Daien, MD, PhD, CHU Lapeyronie and University of Montpellier, Montpellier, France, and was published online in RMD Open.
LIMITATIONS:
Limitations include the nonrandomized nature of the study, possible participation bias and residual confounding, fairly short follow-up, limited power to assess differences in some outcomes, and unknown cost-effectiveness of the programme. 
DISCLOSURES:
The study was funded by Pfizer (France). The authors reported no competing interests.
 
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