Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis

Uta Kiltz¹, Robert B M Landewé^{2

3}, Désirée van der Heijde⁴, Martin Rudwaleit⁵, Michael H Weisman⁶, Nurullah Akkoc⁷, Annelies Boonen^{8

9}, Jan Brandt¹⁰, Philippe Carron^{11

12}, Maxime Dougados^{13

14}, Laure Gossec^{15

16}, Merryn Jongkees¹⁷, Pedro M Machado^{18

19}, Helena Marzo-Ortega²⁰, Anna Molto^{14

21}, Victoria Navarro-Compán²², Karin Niederman²³, Percival Degrava Sampaio-Barros²⁴, Gleb Slobodin²⁵, Filip E Van den Bosch^{12

26}, Astrid van Tubergen⁸, Salima van Weely²⁷, Dieter Wiek²⁸, Juergen Braun²⁹

Affiliations

¹ Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany uta.kiltz@elisabethgruppe.de.
² Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands.
³ Rheumatology, Zuyderland MC, Heerlen, The Netherlands.
⁴ Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany.
⁶ Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, Los Angeles, California, USA.
⁷ Department of Medicine, Division of Rheumatology, Celal Bayar University School of Medicine, Manisa, Turkey.
⁸ Internal Medicine, Division of Rheumatology, Maastrich University Medical Center, Maastricht, The Netherlands.
⁹ Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.
¹⁰ Rheumatology, Private Practice, Berlin, Germany.
¹¹ Rheumatology, Ghent University Hospital, Ghent, Belgium.
¹² VIB Inflammation Research Center, Ghent, Belgium.
¹³ Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France.
¹⁴ INSERM (U1153): Epidémiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France.
¹⁵ Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Sorbonne Universite, Paris, France.
¹⁶ APHP, Rheumatology department, Hopital Universitaire Pitie Salpetriere, Paris, France.
¹⁷ Patient Research Partner, Amsterdam, The Netherlands.
¹⁸ MRC Centre for Neuromuscular Diseases, University College London, London, UK.
¹⁹ Rheumatology, University College London Centre for Rheumatology, London, UK.
²⁰ NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds Faculty of Medicine and Health, Leeds, UK.
²¹ Rheumatology, Hopital Cochin, paris, Ile de France, France.
²² Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain.
²³ School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
²⁴ Faculdade de Medicina da Universidade de São Paulo e Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
²⁵ Department of Internal Medicine A, Bnai Zion Medical Center, Technion, Haifa, Israel.
²⁶ Department of Internal Medicine and Pediatrics, Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium.
²⁷ Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.
²⁸ Patient Research Partner, Huenxe, Germany.
²⁹ Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany.

PMID: 31604704
PMCID: PMC7025729
DOI: 10.1136/annrheumdis-2019-216034

Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis

Uta Kiltz et al. Ann Rheum Dis. 2020 Feb.

. 2020 Feb;79(2):193-201.

doi: 10.1136/annrheumdis-2019-216034. Epub 2019 Oct 11.

Authors

Affiliations

¹ Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany uta.kiltz@elisabethgruppe.de.
² Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands.
³ Rheumatology, Zuyderland MC, Heerlen, The Netherlands.
⁴ Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany.
⁶ Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, Los Angeles, California, USA.
⁷ Department of Medicine, Division of Rheumatology, Celal Bayar University School of Medicine, Manisa, Turkey.
⁸ Internal Medicine, Division of Rheumatology, Maastrich University Medical Center, Maastricht, The Netherlands.
⁹ Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.
¹⁰ Rheumatology, Private Practice, Berlin, Germany.
¹¹ Rheumatology, Ghent University Hospital, Ghent, Belgium.
¹² VIB Inflammation Research Center, Ghent, Belgium.
¹³ Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France.
¹⁴ INSERM (U1153): Epidémiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France.
¹⁵ Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Sorbonne Universite, Paris, France.
¹⁶ APHP, Rheumatology department, Hopital Universitaire Pitie Salpetriere, Paris, France.
¹⁷ Patient Research Partner, Amsterdam, The Netherlands.
¹⁸ MRC Centre for Neuromuscular Diseases, University College London, London, UK.
¹⁹ Rheumatology, University College London Centre for Rheumatology, London, UK.
²⁰ NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds Faculty of Medicine and Health, Leeds, UK.
²¹ Rheumatology, Hopital Cochin, paris, Ile de France, France.
²² Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain.
²³ School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
²⁴ Faculdade de Medicina da Universidade de São Paulo e Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
²⁵ Department of Internal Medicine A, Bnai Zion Medical Center, Technion, Haifa, Israel.
²⁶ Department of Internal Medicine and Pediatrics, Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium.
²⁷ Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.
²⁸ Patient Research Partner, Huenxe, Germany.
²⁹ Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany.

PMID: 31604704
PMCID: PMC7025729
DOI: 10.1136/annrheumdis-2019-216034

Abstract

Objectives: The Assessment of SpondyloArthritis International Society (ASAS) aimed to develop a set of quality standards (QS) to help improve the quality of healthcare provided to adult patients affected by axial spondyloarthritis (axSpA) worldwide.

Methods: An ASAS task force developed a set of QS using a stepwise approach. First, key areas for quality improvement were identified, discussed, rated and agreed on. Thereafter, areas were prioritised and statements for the most important key areas were phrased on consensus. Appropriate quality measures were defined to allow quantification of the QS at the community level.

Results: The ASAS task force, consisting of 20 rheumatologists, two physiotherapists and two patients, selected and proposed 34 potential key areas for quality improvement which were then commented by 140 ASAS members and patients. Within that process three new key areas came up, which led to a re-evaluation of all 37 key areas by 120 ASAS members and patients. Five key areas were identified as most important to determine quality of care: referral including rapid access, rheumatology assessment, treatment, education/self-management and comorbidities. Finally, nine QS were agreed on and endorsed by the whole ASAS membership.

Conclusions: ASAS successfully developed the first set of QS to help improving healthcare for adult patients with axSpA. Even though it may currently not be realistic to achieve the QS in all healthcare systems, they provide high-quality of care framework for patients with axSpA that should be aimed for.

Keywords: ankylosing spondylitis; quality Indicators; spondyloarthritis.

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Conflict of interest statement

Competing interests: AB received research grants to her department from Abbvie and Celgene and honoraria for lectures or consulting fees form UCB, Janssen, Sandoz, Novartis and Eli-Lilly. JB: honoraria for talks, advisory boards, paid consultancies and grants from studies from Abbvie, Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, UCB. PC: honoraria for talks, advisory boards, paid consultancies from Celgene, MSD (Schering-Plough), Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, UCB. MD: honoraria for lectures and advisory board meetings for Pfizer, Abbvie, Merck, UCB, Lilly, Novartis. LG research grants: Pfizer, UCB, Lilly, Bristol-Myers Squibb; honoraria for lectures and advisory board meetings from AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCBU. UK: received grant and research support and consultancy fees from AbbVie, Biogen, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche and UCB. RBML: honoraria for lectures and advisory board meetings for AbbVie, Celgene, Galapagos, Janssen, Lilly, Novartis, Pfizer, UCBP. PMM has received consulting/speaker’s fees from Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB. HM-O: grants from Janssen, Novartis. Speaking, honoraria from Abbvie, Celgene, Eli-Lilly, Janssen, Novartis, Pfizer and UCB. AM: honoraria for lectures and advisory board meetings for AbbVie, BMS, Janssen, MSD, Novartis, Sanofi, Pfizer and UCB.VN-C: consultancy/speaker/research grants from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB. educational/research grants: SAR, SER, SORCOM, EULAR, ASAS. MR: honoraria for presentations or advisory board meetings from Abbvie, Celgene, BMS, Janssen, Lilly, MSD, Novartis, Pfizer, UCB. PS-B: honoraria for presentations or advisory board meetings from Abbvie, Boehringer Ingelheim, Janssen, Novartis, UCB. GS: honoraria for lectures and/or advisory board meetings from Abbvie, Lilly, Novartis, Sanofi, Roche. DvdH: consulting fees AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Daiichi, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma. Director of Imaging Rheumatology AvT received research grants from Pfizer, Abbvie, UCB, Novartis and Biogen and consulting fees from Novartis, Jansen-Cilag, Pfizer, MW: consulting fees from Novartis, Lilly, UCB.

Figures

**Figure 1**
Summary of the nine Assessment of SpondyloArthritis International Society quality statements. SpA, spondyloarthritis.

See this image and copyright information in PMC

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Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis

Affiliations

Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials