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Profound reduction in hospital admissions and musculoskeletal surgical procedures for rheumatoid arthritis with concurrent changes in clinical practice (1995-2010).

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Profound reduction in hospital admissions and musculoskeletal surgical procedures for rheumatoid arthritis with concurrent changes in clinical practice (1995-2010).

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Harty, Len O'Toole, Gary FitzGerald, Oliver
Description	Country affiliation: Ireland Author Affiliation: Harty L ( Department of Rheumatology and Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland. lenharty@yahoo.com.); O'Toole G ( Department of Rheumatology and Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland.); FitzGerald O ( Department of Rheumatology and Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland.)
Abstract	OBJECTIVES: The aims of this study were to audit the annual national incidence of inpatient days and musculoskeletal surgical procedures (MSKSPs) for RA patients and to establish concurrent changes in clinical rheumatology practice from 1995 to 2010. METHODS: Hospital inpatient enquiry systems were evaluated for 57 hospitals from 1995 to 2010. National annual TNF inhibitor (TNFi) and MTX prescriptions were analysed. Trends were analysed by logistic regression and correlations by Spearman's rho. RESULTS: Fifty-four thousand eight hundred and six RA inpatient records were reviewed from 1995 to 2010 [70% female, mean age 66 years (s.d. 16)]. RA inpatient days decreased from 53 671 in 1995 to 29 000 in 2010 (r(2) = 0.8, P < 0.0001). Inpatient MSKSPs for RA patients decreased from a peak of 370 in 1996 to 188 in 2010 (r(2) = 0.7, P < 0.0001). Knee and hip replacements for the general population annually increased over the past 15 years, yet there was a significant decrease in the annual ratio of hip arthroplasties and knee arthroplasties for RA patients compared with those done for the general population from 1995 to 2010 (r(2) = 0.6, P < 0.001 and r(2) = 0.8, P < 0.01, respectively). Annual national TNFi prescriptions increased from 2389 units in 2000 to 116 747 in 2010. Concurrently MTX prescriptions increased nationally from 3300 in 2001 to 9600 in 2010. During the same period there was an increase in rheumatologists from 15 to 40 and in orthopaedic surgeons from 64 to 88. CONCLUSION: Elective MSKSPs for RA patients have almost halved over the past 15 years, despite an increase in hip and knee arthroplasties for the general population, along with an almost halving of inpatient days for RA patients.
File Format	HTM / HTML
ISSN	14620324
e-ISSN	14620332
Journal	Rheumatology
Issue Number	4
Volume Number	54
Language	English
Publisher	Oxford University Press
Publisher Date	2015-04-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Rheumatology Antirheumatic Agents Therapeutic Use Arthritis, Rheumatoid Therapy Hospitalization Methotrexate Orthopedic Procedures Rheumatology Tumor Necrosis Factor-alpha Antagonists & Inhibitors Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Logistic Models Outcome Assessment (health Care) Retrospective Studies
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical) Rheumatology

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