Factors associated with use of disease modifying agents for rheumatoid arthritis in the National Hospital and Ambulatory Medical Care Survey
Section snippets
Significance and innovations
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The recent-most U.S. national survey of outpatient physician visit data shows that 76.8% visits among RA patients are associated with any DMARD use while 31.7% are associated with specifically biological DMARD use.
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Our results indicate that the type of insurance coverage and provider are significant indicators of RA treatment with traditional and biological DMARDs.
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Type of coverage may be a better indicator of DMARD treatment use than patient race/ethnicity and therefore, inadequate coverage may
Data source
The National Ambulatory Medical Care Survey (NAMCS) is a publicly available data collected through a national survey designed for information on the utilization and provision of ambulatory care services in hospital emergency and outpatient department visits. The data source is a nationally representative probability sample of office-based physician practices and outpatient settings across the US that uses a multistage cluster strategy to select physicians in hospital and outpatient settings by
Results
Among the total visits recorded over 2005–2014, n = 1405 were associated with RA. Among these the majority (76.3% [weighted]; n = 1092) were females and non-Hispanic White (74.9% [weighted]; n = 953). Additionally, 8.7% (weighted) (n = 243) were less than 45 years of age, 33.2% (weighted; n = 479) were 45 to <60 years of age, while 58% (weighted; n = 683) were 60 years or older. Overall, of the total treatment-related visits, 76.8% (n = 807) were associated with any DMARD use while 31.7% (n =
Discussion
Our assessment of factors associated with DMARD treatment using the recent-most available nationally representative data on outpatient physician visits yielded the following findings. First, a significantly higher distribution of males, visits in the Southern region, those with private insurance and three or more comorbidities were found among any DMARD-related visits while a significantly higher distribution of privately insured and age <45 years were found among bDMARD-related visits. Second,
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2021, Joint Bone SpineCitation Excerpt :These recommendations have led to an update of the therapeutic guidelines formulated by the French Society of Rheumatology (SFR), which are in France the reference for patient care [8]. The prescription of DMARDs has increased during the last decades [9], coinciding with the introduction of bDMARDs on the market. The first available TNF blockers were infliximab and etanercept in 2000, followed by adalimumab in 2003.
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2020, Seminars in Arthritis and RheumatismCitation Excerpt :Large variations were also noted in reported medication use, with use of NSAIDs ranging from 11.8% to 82.8% and that of biologic disease modifying anti-rheumatic drugs (DMARDs) ranging from 16.1% to 100%. Of ambulatory care visits for patients with RA, 76.8% were associated with use of a DMARD, with 31.7% of visits associated with use of a biological DMARD [27]. The extent to which use of a biologic DMARD alleviates reported barriers to physical activity (e.g., pain and fatigue) and thereby enables more patients with SpA or RA to exercise is unknown.
Funding: Priyanka Gaitonde, MS is supported as a Maryland CERSI scholar (FDA grant 1U01FD005946); Laura M. Bozzi, MS is funded by the NIA T32 AG00262