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. 2018 Mar;77(2):113-126.
doi: 10.1007/s00393-017-0381-6.

[Prevalence, comorbidity and interdisciplinary treatment of rheumatoid arthritis - Insurance data on outpatient and inpatient care in Baden-Württemberg]

[Article in German]
A Strahl  1 , O Schneider  2 , J Frankenhauser-Mannuß  2 , S Knapstein  2 , C Hermann  2 , B Lembeck  3 , H-M Lorenz  4   5 , W Rüther  1 , J Flechtenmacher  6   7
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[Prevalence, comorbidity and interdisciplinary treatment of rheumatoid arthritis - Insurance data on outpatient and inpatient care in Baden-Württemberg]

[Article in German]
A Strahl et al. Z Rheumatol. 2018 Mar.

Abstract

Background: Rheumatoid arthritis (RA) has an increased number of comorbidities compared with the general population.

Objective: Study aim was to collect epidemiological data on prevalence, incidence and comorbidities of RA as well as utilization of outpatient and inpatient care services.

Material and methods: In an age and gender-adjusted case control study, a total of 3.4 million patients insured by the AOK Baden-Württemberg were analysed with respect to visits to physicians, prevalence, incidence and comorbidities of RA. The study was based on out- and inpatient diagnoses from 2013.

Results: The RA prevalence was 0.64% (n = 26,919), the incidence was 0.04%. Patients with RA have significant more comorbidities in almost all diagnosis groups, especially in musculoskeletal and cardiovascular diseases, compared to a control group (n = 181,209). 22.8% of RA patients had not contacted an internist rheumatologist, orthopedist or orthopedic surgeon. Biological disease-modifying anti-rheumatic drugs (DMARDs) were almost exclusively prescribed by internist rheumatologists, while conventional DMARDs were equally prescribed by general practitioners and rheumatologists. Of the RA patients 32.6% were hospitalized at least once a year and were nearly twice as frequently inpatient as the control group.

Conclusion: RA patients need more in- and outpatient healthcare services and suffer significantly more often from comorbidities. The general practitioner is the most frequently visited physician. Other consulted physicians are rheumatologists, ophthalmologists, orthopedists/orthopedic surgeons and internists not specialized in rheumatology. The study highlights the need to create consensus treatment algorithms and maintain a close interdisciplinary and intersectoral cooperation and communication.

Keywords: Comorbidity; Health insurance data; Medical healthcare; Prevalence; Rheumatoid arthritis.

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