Multimodal rheumatologic complex treatment of rheumatoid arthritis-amonocentric retrospective analysis

Abstract

Multimodal rheumatologic complex treatment (MRCT, operation and procedures classification system, OPS code 8‑983) is aspecific concept of acute inpatient care (DRG I97Z) for treatment of patients with rheumatic diseases, degenerative diseases and/or chronic pain syndromes suffering from exacerbated pain and functional impairment. Amonocentric retrospective analysis of the effects of MRCT on pain and functional status in patients with rheumatoid arthritis (RA) was conducted. Atotal of 103 treatment episodes in 75patients with proven RA who received MRCT between 2014 and 2017 were included in the analysis. The changes in pain intensity were evaluated using anumerical rating scale (NRS), the functional limitations as assessed by the Hanover function questionnaire (FFbH) and the health assessment questionnaire (HAQ) and the disease activity (disease activity score of 28joints, DAS28) before and after MRCT episodes. In addition, the patient characteristics and the course of the disease were documented and a univariate analysis of the influence of these factors on the parameters activity and function was performed. In patients with RA, the MRCT resulted in asignificant amelioration of pain (p < 0.0001), asignificant improvement of functional capacity (FFbH p = 0.0013, HAQ p = 0.1396) and asignificant reduction of disease activity (DAS28 p < 0.0001). Different aspects of the disease and its previous course (e. g. disease duration, type and number of previous anti-rheumatic drugs, current medication) did not have asignificant effect on the response. This retrospective monocentric analysis proved the efficacy of MRCT with respect to the inpatient treatment period in alarge cohort of RA patients. This treatment concept not only improved pain and function (FFbH) but also significantly reduced the disease activity.