Care of RA patients falls ‘far short’ of national guidelines

Rheumatoid arthritis patients who see a rheumatologist in addition to their usual healthcare provider, receive the best care for their condition, according to a new study. Primary care physicians vary in their ability to deal with the disease and may lack knowledge of the RA patients’ specific needs.

“Patients need to be aware that the quality of care they’re going to receive can vary from doctor to doctor,” commented Catherine MacLean, M.D., Ph.D., assistant professor of medicine at the University of California, Los Angeles.

While emphasizing the important role primary care physicians play in the care of chronic diseases, the study found that arthritis patients received the best care with the help of a rheumatologist.

The research, published in the Journal of the American Medical Association, states that only about half of the 1,176 patients studied saw a specialist. These patients “received substantially higher quality care along all measures of health care quality than did patients who did not. This finding is particularly noteworthy since nearly half of our study population never saw a specialist.”

The patients who visited a rheumatologist benefited from additional procedures used to monitor their health more closely; for example, they received better blood monitoring and the effects of drugs were tracked. The UCLA medical team reported that overall, RA patients with specialized care received the additional care measures 76% of the time, while those who only saw a primary care physician received appropriate specialized care only 47% of the time.

The researchers saw a definite need for this kind of study as there was no previous information available about how a physician specialty affects quality of care in patients with a single chronic condition, such as rheumatoid arthritis.

Rheumatoid arthritis affects about 1% of adults in the United States and can lead to a 5-to-15 year reduction in life expectancy. The autoimmune disease causes progressive destruction of the joints with painful symptoms of swelling, inflammation and stiffness.

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