Rheumatology certified staff-led care for rheumatoid arthritis patients admitted to departments other than rheumatology
2020 Volume 32 Issue 3 Pages 220-227
Details
2020 Volume 32 Issue 3 Pages 220-227
Background: Patients with rheumatoid arthritis（RA）are often hospitalized for treatment of cancer, trauma, and cardiovascular event into departments other than rheumatology. Some patients might need medication adjustments for disease-modifying anti-rheumatic drugs. In addition, patients with disabilities in their daily activities may find it inconvenient or difficult to spend time in a hospital environment. In such settings, rheumatology certified staff should provide appropriate care to these patients. However, information about these issues is sparse.
Objectives: To investigate the background of RA patients admitted to departments other than rheumatology, and to clarify whether these patients need management by rheumatology certified staff to adjust medications or the hospital environment.
Patients and methods: Between October 1, 2018 and May 31, 2019, RA patients referred to the rehabilitation department from departments other than rheumatology were enrolled. Patients’ background, medications for RA, and ability to perform daily life activities were obtained from medical records.
Results: Of 2,687 patients referred to the rehabilitation department, 51 RA patients（1.9%）were identified. The average age was 75.8 years old and there were 39 women（76%）. The average Functional Independence Measure（FIM）was 70.7 points. Thirty patients（59%）had received RA treatment at other facilities. Thirty（59%）patients were hospitalized urgently for acute illness or trauma. Usage rates for prednisolone, methotrexate, and biologics were 76%, 31%, and 20%, respectively. Rheumatology-certified staff intervened in 13 cases（25%）; 3 involved rehabilitation and 15 were related to medication adjustment.
Conclusions: Some RA patients admitted to departments other than rheumatology needed adjustment of medications or their daily environment. A multidisciplinary approach is needed to provide care led by certified staff during hospital stays for treating diseases other than rheumatic conditions.
