Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes):
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Rheumatology International https://doi.org/10.1007/s00296-020-04632-2
INTERNATIONAL
OBSERVATIONAL RESEARCH
Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain Emilio Ignacio García1 · Mercedes Guilabert2 · Rubén Queiro3 · Irene Carrillo2,4 · José Joaquín Mira2,5,6 Received: 3 May 2020 / Accepted: 15 June 2020 © The Author(s) 2020
Abstract In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain. Keywords Psoriatic arthritis · Multidisciplinary · Quality assurance · Quality standard Abbreviations CRP C-reactive protein DAPSA Disease activity in psoriatic arthritis ESR Erythrocyte sedimentation rate EULAR European league against rheumatism GRAPPA Group for Research and Assessment of Psoriasis and Psoriatic Arthritis MDA Minimal disease activity MRI Magnetic resonance imaging PsA Psoriatic arthritis PsAID Psoriatic arthritis impact of disease
* Mercedes Guilabert [email protected] Extended author information available on the last page of the article
Introduction Psoriatic arthritis (PsA) is a chronic, progressive, multiorgan disease [1] common (10–20%) among patients suffering from psoriasis. It presents a relapsing course throughout life, with periods of inactivity and others of inflammation and pain. The EPISER study [2] has established the prevalence of PsA in Spain in 0.58% of the population over 18 years of age. GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) [3] has studied worldwid
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