Methodological approaches to the use of the Register of children with juvenile arthritis at the level of specialized medical care

Abstract

Juvenile arthritis (JA) is a disease of unknown etiology that begins before the age of 16 years and lasts for at least 6 weeks. The main objective of most existing international registers of children with JA is assessment various aspects of the efficacy and safety of biologics in comparison with methotrexate. The results of the analysis of the effectiveness of registers as a tool for long-term monitoring of the disease and medical care for children with JA are not presented in the available literature. The aim of the study is to develop methodological approaches to maintaining the Register of children with JA and algorithms of actions of medical personnel on the basis of the experience of the Republican Children's Clinical Hospital (Ufa). This work is a retro- and prospective observational study. The Register included children under the age of 18 years with an established diagnosis of JA, who were admitted to the cardio-rheumatologic department of Republican Children's Clinical Hospital (Ufa). In this paper, we used the All-Russian register of children with JA, developed by «Aston Consulting» and «Norbit» (official partner of Microsoft) on the basis of the technological platform Microsoft Dynamics CRM 5.0. In total, the Register included information about 426 children with JA. The average age of children during the analysis of the register data was 10.9±4.3 years, and in the onset of the disease – 4.7±3.7 years. According to the results of the analysis, the tasks, areas of responsibility and scope of action for each subject of medical care (rheumatologist of rheumatology hospital and office, head of department, chief freelance specialist of the Ministry of Health) and the corresponding tools of the Register were determined. A clear algorithm of actions of specialists depending on the task will optimize the work with the register of patients, reduce the time required to enter and receive information and, at the same time, provide the possibility of the most complete and effective use of the Register in optimizing medical care for children with JA.