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This study evaluated the associations between achieving treatment goals and patient-reported outcomes (PROs) and healthcare resource utilisation (HCRU) among patients with rheumatoid arthritis (RA) on advanced treatment.
Retrospective cohort analyses of deidentified data from an established registry.
US-based single-centre registry between 2003 and 2024.
Data from patients with RA in the Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study registry were analysed using multivariable regression analyses. Patients were classified into four groups based on Clinical Disease Activity Index (CDAI) scores at baseline and 1 year (consistently at/not at target, gain or lose target). Patients who were consistently at target were further classified into remission, very low disease activity (LDA) and LDA subgroups.
PROs (Multidimensional Health Assessment Questionnaire (MDHAQ) overall, pain, fatigue scores) and HCRU (surgery rates, durable medical equipment (DME) use) were assessed over 2 years.
The primary endpoint compared MDHAQ PROs and surgery and DME HCRU among the four primary groups. The secondary endpoint assessed the association between maintaining LDA and achieving remission at follow-up with PROs and HCRU.
Among 637 patients with CDAI data, 257 (40%) had LDA at baseline; 57 (22%) lost target at 1 year. Of 380 (60%) patients with CDAI >10 at baseline, 115 (30%) attained LDA. Patients not attaining LDA had higher surgery risk, DME use and MDHAQ scores. Of 200 (31%) patients with LDA at baseline and 1 year, 89 (45%) achieved remission, 79 (40%) very LDA and 32 (16%) LDA. Remission was associated with reduced DME use (adjusted OR (AOR) 5.4 (95% CI 1.9 to 15.4) at year 1 and AOR 4.4 (95% CI 1.7 to 11.1) at year 2) and improved MDHAQ scores compared with LDA (overall unadjusted mean 0.07 vs 0.5 at year 1 and 0.09 vs 0.4 at year 2; p
Achieving and maintaining LDA is challenging for patients with RA but leads to better functional outcomes and reduced DME use. Patients who achieve remission have further improvements.
by Ariffin Kawaja, Aminath Shiwaza Moosa, Eric Kam Pui Lee, Ian Kwong Yun Phoon, Andrew Teck Wee Ang, Zi Ying Chang, Aileen Chelsea Ai’En Lim, Jonathan Yap, Weiting Huang, Ding Xuan Ng, Melvin Yuansheng Sng, Hao Yuan Loh, Chirk Jenn Ng
IntroductionRecent hypertension guidelines recommend ambulatory blood pressure monitoring (ABPM) for accurate diagnosis and monitoring. However, patients’ experiences with cuff and wearable ABPM devices in primary care remain unclear. This study compared the acceptance of three devices (oscillometry cuff, tonometry wrist, and photoplethysmography chest devices) among patients with hypertension in primary care.
MethodsA multi-method study was conducted. Thirty-five participants with hypertension were recruited from two public primary care clinics in Singapore. All participants used cuff-based and either wrist or chest wearable devices for 24 hours. Structured surveys and in-depth audio-recorded interviews were used to gather feedback on their views, experiences, and challenges using the devices. The interviews were thematically analysed, and the surveys were analysed using descriptive statistics.
ResultsAll participants used the cuff (n = 35) device, while the wrist and chest devices were used by two-thirds (n = 22) and a third (n = 11) of the participants, respectively.The device usability questionnaire found that most participants were satisfied with the chest device, which did not disrupt their daily activities. Conversely, cuff arm devices interfered with daily activities (48%) and sleep (26%), were cumbersome (32%), and caused embarrassment (26%). The wrist device was uncomfortable (33%) and painful (22%) for some participants.The qualitative data were categorised into five themes: comfort, convenience, perceived accuracy, and impact on routine and sleep. Participants found the chest device more comfortable and convenient than the cuff and wrist devices. The cuff device was perceived as the most accurate due to its inflation-based BP measurement. All devices minimally affected routines and sleep, though participants expressed safety concerns about the cuff device, particularly while driving.
ConclusionWhile wearable ABPM devices offer increased comfort, convenience and reduced impact on patient’s daily activities, concerns regarding their accuracy must be addressed before the widespread adoption of these devices in routine clinical practice.
FreshRSS 