Tag: Veterans with RA

The Quality of Care study objective was to determine the proportion of US Veterans with Rheumatoid Arthritis nationwide receiving care in VA who were prescribed a DMARD annually over the past decade and, for 2017, to identify Veteran- and system-level correlates of DMARD receipt. Past reports have suggested that the quality of care in general among Veterans is higher than patients who receive non-VA care with respect to many quality indicators. It is largely unknown, however, to what degree Veterans with rheumatoid arthritis (RA) — who are disproportionately male in contrast to the general RA population and may be of lower socioeconomic status — receive high-quality rheumatologic care. Using administrative health data, we determined the annual proportion of Veterans with RA who received a disease-modifying anti-rheumatic drug (DMARD) increased from a rate of 76% in 2006 to 85.6% in 2017. Additional factors such as female sex, age >80, and substance use disorder, Rheumatology shortage area, lower facility-level complexity, and residing in the Southeast region were associated with lower rates of DMARD receipt.  In a separate nationwide survey study, VA rheumatology clinicians reported suboptimal experience and satisfaction with telerheumatology. Clinicians agreed that telehealth is essential to increasing access to care and indicated that telerheumatology is most useful for managing, as opposed to diagnosing, rheumatologic conditions but the inability to perform a physical exam, the training of presenters at the patient sites, and phase of care were all identified as barriers. RA has been associated with a two-fold increased mortality risk compared to the general population, with a heightened risk among males with RA.  Given the makeup of the VA RA population and increased mortality among men with RA, it is imperative that Veterans with RA receive high-quality care.