Effectiveness of a checklist for the control of the disease activity in patients with axial spondyloarthritis

Abstract

Objectives: To assess the effectiveness of a checklist for disease activity and comorbidity control in patients with axial spondyloarthritis (axSpA).

Method: A quasi-experimental retrospective multicentre pre-post intervention study was carried out in Spain between 2016 and 2022. Improvement in disease activity and comorbidity status was determined before and after the implementation of a checklist control in patients diagnosed with axSpA. Disease activity was determined by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels. Comorbidity status was determined by analysing several risk factors (blood pressure, body weight, blood test, etc.). An analysis of variance with mixed models between pre and post collected values was performed. The change in therapeutic level and disease status (low activity, remission) was determined by means of the Mc-Nemar asymmetry test.

Results: A total of 108 patients with axSpA were included in the study. After checklist implementation, a statistically significant reduction in BASDAI of 0.44 (95%CI: 0.06-0.82, p=0.023) and a significant reduction of 3.82mg/L (p=0.001) in CRP was observed. Besides, an increase in uricemia of 0.24mg/dl was found (95%CI: 1.49-6.14, p=0.001), while no other statistically significant change in comorbidities was observed.

Conclusions: The implementation of a checklist in daily clinical practice leads to a significant improvement in the control of disease activity in patients with axSpA.

Keywords: Actividad de la enfermedad; Axial spondyloarthritis; Checklist; Daily practice; Disease activity; Espondiloartritis axial; Lista de control; Práctica diaria.