Delegation ärztlicher Leistungen an rheumatologische Fachassistenten

Effekte auf Depression und Angst bei Patienten mit rheumatoider Arthritis

verfasst von: Juliana Rachel Hoeper, Florian Schuch, Patricia Steffens-Korbanka, Georg Gauler, Martin Welcker, Jörg Wendler, Ulrich von Hinüber, Sara Eileen Meyer, Andreas Schwarting, Jan Zeidler, Torsten Witte, Dirk Meyer-Olson, Kirsten Hoeper
Abstract: Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.
Organisationseinheit(en): Center for Health Economics Research Hannover (CHERH)
Externe Organisation(en): Medizinische Hochschule Hannover (MHH)
Rheumapraxis an der Hase, Osnabrück
MVZ für Rheumatologie Dr. Martin Welcker GmbH
Praxis für Rheumatologie und Osteologie Hildesheim
Johannes Gutenberg-Universität Mainz
RZ Rheumazentrum Rheinland-Pfalz GmbH
m&i Fachklinik Bad Pyrmont
Internistische Praxisgemeinschaft Rheumatologie - Nephrologie Erlangen
Typ: Artikel
Journal: Zeitschrift fur Rheumatologie
Band: 83
Seiten: 407-415
Anzahl der Seiten: 9
ISSN: 0340-1855
Publikationsdatum: 06.2024
Publikationsstatus: Veröffentlicht
Peer-reviewed: Ja
ASJC Scopus Sachgebiete: Rheumatologie
Elektronische Version(en): https://doi.org/10.1007/s00393-023-01403-9 (Zugang: Offen)

BibTeX

@article{dba89caa305e419880a7ee48afdf242e,
title = "Delegation {\"a}rztlicher Leistungen an rheumatologische Fachassistenten: Effekte auf Depression und Angst bei Patienten mit rheumatoider Arthritis",
abstract = "Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.",
keywords = "Comorbidity, Disease process, Outpatient care, Screening, Team based care",
author = "Hoeper, {Juliana Rachel} and Florian Schuch and Patricia Steffens-Korbanka and Georg Gauler and Martin Welcker and J{\"o}rg Wendler and {von Hin{\"u}ber}, Ulrich and Meyer, {Sara Eileen} and Andreas Schwarting and Jan Zeidler and Torsten Witte and Dirk Meyer-Olson and Kirsten Hoeper",
note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",
year = "2024",
month = jun,
doi = "10.1007/s00393-023-01403-9",
language = "Deutsch",
volume = "83",
pages = "407--415",
journal = "Zeitschrift fur Rheumatologie",
issn = "0340-1855",
publisher = "D. Steinkopff-Verlag",
number = "5",
}