Optimize outpatient care in spondyloarthritis and psoriatic arthritis

Spondyloarthritis is a group of rheumatic diseases that includes pathologies such as ankylosing spondylitis, psoriatic arthritis, spondyloarthropathies associated with inflammatory bowel disease or reactive arthritis. Its prevalence is estimated to exceed 1.2% of the population, which is equivalent to approximately half a million people affected in Spain.,

These are practically all chronic patients who must be provided with close and effective care in order to organize provision in the best possible way. With exactly the same purpose, within PROMuve initiative promoted by Novartis, Elche Hospital have developed an innovation project so that, through the interaction of the services caring for these patients, basically rheumatology and hospital pharmacy, they can provide the most appropriate service to these patients.

Ana García Monsalve, head of the outpatient unit of the hospital pharmacy service of the Levantine Center, explains that, although the service also provides this type of care to other patients, it began in cases of diseases related to both spondyloarthritis and psoriatic arthritis. . To develop a little over a year ago. ,These are chronic patients on biologic drug treatment”, who have to be seen by both rheumatology and the hospital pharmacy. In total, 369 patients were treated by the pharmacy last year, making 1,993 visits.

“First of all, what we did was use the LEAN methodology; Hold a few meetings, first look at each member of the care team taking care of the patient, assess what they did, or what they have done so far, and how we coordinated. We analyzed the time elapsed,delays caused by unnecessary repetition of processes. In a way it was about seeing how the system worked and how it could be improved.Garcia explains.

With this, both services managed to “coordinate and eliminate things that did not add value and optimize response times to improve the treatment of these patients.” “This is how the process map was born, which is the basis for optimizing service time.”

This project in terms of methodology and process map started a year ago and is now in the hospital “We are already regularly following the process we have set for ourselves,” says the pharmacist. “Rheumatology, rheumatology nursing, pharmacy and the quality department of the hospital” participate in the project and The service is provided to all patients who attend. There are two or three diagnoses per patient.

Before any initiation or change of treatment, there is a joint committee of pharmacy and rheumatology, which assesses the appropriateness of the change of medication on a case-by-case basis and then “When the patient receives treatment from the pharmacy, Let’s make him an appointment at that time to start that treatment.” “Currently we do pharmaceutical care consultations in the office to see if the patient has any contraindications, the safety of the medication and direct information to the patient.”

(Tags to translate)psoriatic arthritis

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