Authors:	Dreher, Matthias Witte, Torsten Hoeper, Kirsten Assmann, Gunter Proft, Fabian Poddubnyy, Denis Murawski, Niels Triantafyllias, Konstantinos Grodd, Marlon Graf, Erika Fichtner, Urs A Binder, Harald Zeidler, Jan Hoeper, Juliana Rachel Callhoff, Johanna Karberg, Kirsten Trautwein, Anna Tibyampansha, Dativa Wojnowski, Leszek Schmidt, Reinhold E Schwarting, Andreas
Title:	Rheuma-VOR study: optimising healthcare of rheumatic diseases by multiprofessional coordinating centres
Online publication date:	13-Mar-2024
Year of first publication:	2024
Language:	english
Abstract:	Objectives: Early diagnosis of inflammatory arthritis is critical to prevent joint damage and functional incapacities. However, the discrepancy between recommendations of early diagnosis and reality is remarkable. The Rheuma-VOR study aimed to improve the time to diagnosis of patients with early arthritis by coordinating cooperation between primary care physicians, specialists and patients in Germany. Methods: This prospective non-randomised multicentre study involved 2340 primary care physicians, 72 rheumatologists, 4 university hospitals and 4 rheumatology centres in 4 German Federal States. The two coprimary endpoints (time to diagnosis and screening performance of primary care physicians) were evaluated for early versus late implementation phase. Additionally, time to diagnosis and secondary endpoints (decrease of disease activity, increase in quality of life and overall well-being, improvement of fatigue, depression, functional ability, and work ability, reduction in drug and medical costs and hospitalisation) were compared with a reference cohort of the German Rheumatism Research Centre (DRFZ) reflecting standard care. Results: A total of 7049 patients were enrolled in the coordination centres and 1537 patients were diagnosed with a rheumatic disease and consented to further participation. A follow-up consultation after 1 year was realised in 592 patients. The time to diagnosis endpoint and the secondary endpoints were met. In addition, the calculation of cost-effectiveness shows that Rheuma-VOR has a dominant cost–benefit ratio compared with standard care. Discussion: Rheuma-VOR has shown an improvement in rheumatological care, patient-reported outcome parameters and cost savings by coordinating the cooperation of primary care physicians, rheumatologists and patients, in a nationwide approach.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-10191
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY-NC
Information on rights of use:	https://creativecommons.org/licenses/by-nc/4.0/
Journal:	Annals of the rheumatic diseases 83
Pages or article number:	184 193
Publisher:	BMJ
Publisher place:	London
Issue date:	2024
ISSN:	1468-2060
Publisher DOI:	10.1136/ard-2023-224205
Appears in collections:	DFG-491381577-H