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Master Thesis

Évaluation de l’adhérence aux recommandations concernant le dépistage systématique des comorbidités associées aux rhumatismes inflammatoires chroniques dans la pratique quotidienne : les patients fumeurs suivent moins bien les préconisations

Abstract : Background: In chronic inflammatory rheumatic diseases, comorbidities are more frequently observed than in general population and are sub optimally screened and managed. We aimed at assessing the implementation of recommendations 12 to 18 months after the systematic screening of comorbidities according to EULAR points to consider. We also aimed at characterizing predictive factors of non-compliance to the recommendations. Methods: We included 100 patients with rheumatoid arthritis or spondyloarthritis, initiating a biologic Disease-modifying anti-rheumatic drug. Data regarding compliance to recommendations were collected in medical charts or by phone interview, 12 and 18 months after the standardized screening in hospital day care. Results: 242 recommendations were made; 95.8% patients had at least one recommendation. 12 to 18 months after the standardized screening, 34.3 % of the recommendations remained unsatisfied and 58.7% patients didn’t follow all the recommendations made; 20.0% regarding infection prevention, 25.5% regarding cardiovascular prevention, and 34.4% for cancer screening. Surprisingly, our results show that recommendations of commencing bisphosphonate have not been followed. We found no difference in the overall number of recommendations made according to disease, age, gender, bDMARD line, disease duration, disease activity, pain, global health assessment, rheumatologist setting. Smokers were less likely to followed recommendations (OR 3.4 95%CI (1.8-6.3)). Conclusion: These data suggest good implementation of recommendation made upon a systematic screening of comorbidities.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02572286
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Submitted on : Wednesday, May 13, 2020 - 3:43:00 PM
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Sally Dereymez. Évaluation de l’adhérence aux recommandations concernant le dépistage systématique des comorbidités associées aux rhumatismes inflammatoires chroniques dans la pratique quotidienne : les patients fumeurs suivent moins bien les préconisations. Médecine humaine et pathologie. 2020. ⟨dumas-02572286⟩

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