RA Comorbidity Management: Multidisciplinary Team Care Model Essential

Rheumatologists ‘ concerns about prescribing disease-modifying antirheumatic medicines (DMARDs) or other biological agents in comorbidity patients are currently high: according to 1 cross-sectional global study,3 biological DMARD (bDMARD) uses “reductions of 11% for each extra chronic morbidity” in multimorbidity patients.
In another research, researchers discovered that rheumatological care was often deprioritized by patients with both RA and an elevated amount of comorbidities. Although these patients may “attribute less significance to RA management owing to the burden of comorbidities,” rheumatologists may also delay bDMARD therapy owing to potential complications associated with comorbidity.
In an article released in Joint Bone Spine,5 Laure Gossec, MD, PhD, of the Sorbonne University in Paris, France, and peers created a set of leadership suggestions for the compilation as well as reporting of 6 chosen patient comorbidities, based on the rules of the European League of Against Rheumatism: ischemic cardiovascular diseases, diverticulitis, malignancies, depression, osteoporosis, infections.
With a literature review and consensus process, scientists attempted to collate published as well as unpublished comorbidity care management suggestions, including “writing prescriptions, testing practices, therapy introductions, and/or referrals to other suitable health care professionals.” Ultimately, suggestions were detailed for each comorbid disorder, including suggested measures for individual rheumatologist treatment.
Possibly avoidable hospital admissions include another danger associated with comorbidities. Researchers have recently discovered that the percentage of hospitalization rises relative to the number of comorbid circumstances — up to 55% among patients with greater than or eight comorbidities.
While Dr. Roubille and peers note that not all comorbidities are equivalent, severity plays a part, They indicate that the most appropriate course of action for co-morbidity leadership may be to examine the impact of separate co-morbidity organizations on identifying subsets of RA patients who need to be closely controlled and who could benefit best from a multidisciplinary strategy.
Integrated care takes time, the writers observed, adding that, despite best efforts, it may be hard to integrate comorbidity management into a “classical visit.” Researchers should avoid creating an” RA paradox” in which specific care modalities compete with the overall care plan of a patient.