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. 2015 Dec;2(2):141-151.
doi: 10.1007/s40744-015-0018-7. Epub 2015 Oct 1.

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis

Tamar Sapir  1 , Erica Rusie  2 , Laurence Greene  2 , Jinoos Yazdany  3 , Mark L Robbins  4 , Eric M Ruderman  5 , Jeffrey D Carter  2 , Barry Patel  6 , Kathleen Moreo  2
Affiliations

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis

Tamar Sapir et al. Rheumatol Ther. 2015 Dec.

Abstract

Introduction: In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits.

Methods: Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence.

Results: Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts).

Conclusion: This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve performance on national quality measures for RA.

Keywords: Chart audit; Continuing medical education; Physician Quality Reporting System; Quality improvement; Quality measures; Rheumatoid arthritis.

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Figures

Fig. 1
Fig. 1
Baseline and post-education rates of performance on PQRS quality measures for rheumatoid arthritis. For all measures other than TB screening before initiating biologic DMARD therapy, adherence rates were based on 160 baseline charts and 160 post-education charts. Analyses for TB screening were based on charts of patients who, in accordance with the quality measure, had received a first course of therapy using a biologic DMARD (n = 71 baseline charts; n = 77 post-education charts). DMARD disease-modifying antirheumatic drug, PQRS Physician Quality Reporting System, TB tuberculosis
Fig. 2
Fig. 2
Baseline and post-education rates of patient counseling and assessments of medication side effects and adherence
See this image and copyright information in PMC

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