Vasculitis & polymyalgia rheumatica
Identifying key health system components associated with improved outcomes to inform the re-configuration of services for adults with rare autoimmune rheumatic diseases: a mixed-methods study
Authors' conclusion
Key service components associated with important health outcomes and underpinning factors were identified to inform initiatives to improve the design, delivery, and effectiveness of health-care models for rare autoimmune rheumatic diseases.
Study context
- Population
- Adults with AAV identified from national health datasets in Scotland; vasculitis service providers across the UK and IrelandAAV patients, data linkage
- Participants
- 1,420 adults
- Exposure
- Presence vs absence of key service components
- Outcome
- Service components associated with patient and provider outcomes
Methodological detailssurvey of vasculitis service providers, patient interviews, organisational case studies, population-based data linkage study, Bayesian poisson and negative binomial regression, Cox proportional hazards models, People with lived experiences were involved in the research and writing process
- Survey of vasculitis service providers
- Patient interviews
- Organisational case studies
- Population-based data linkage study
- Bayesian poisson and negative binomial regression
- Cox proportional hazards models
- People with lived experiences were involved in the research and writing process
Main finding
As reported in the abstract
- Waiting times <1 week: serious infections, IRR
- 0.70 [0.55-0.88] (95% CrI)
- Waiting times <1 week: emergency hospital admissions, IRR
- 0.78 [0.68-0.92] (95% CrI)
- Waiting times <1 week: mortality, HR
- 0.59 [0.37-0.93] (95% CrI)
- Nurse-led advice lines: serious infections, IRR
- 0.76 [0.58-0.93] (95% CrI)
- Nurse-led advice lines: emergency hospital admissions, IRR
- 0.85 [0.74-0.96] (95% CrI)
- Cohorted clinics: serious infections, IRR
- 0.75 [0.59-0.96] (95% CrI)
- Cohorted clinics: emergency hospital admissions, IRR
- 0.81 [0.71-0.91] (95% CrI)
- Nurse-led clinics: serious infections, IRR
- 0.65 [0.39-0.84] (95% CrI)
- Nurse-led clinics: emergency hospital admissions, IRR
- 0.75 [0.65-0.94] (95% CrI)
- Specialist vasculitis MDT meetings: serious infections, IRR
- 0.72 [0.57-0.90] (95% CrI)
- Specialist vasculitis MDT meetings: emergency hospital admissions, IRR
- 0.86 [0.75-0.96] (95% CrI)
Observational data: associations, not effects.
Original publication
Identifying key health system components associated with improved outcomes to inform the re-configuration of services for adults with rare autoimmune rheumatic diseases: a mixed-methods study. Lancet Rheumatol. Published June 2024. doi:10.
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