Standards of care (WP5)

Work package Leader: Medizinische Universit├Ąt Wien, Austria
Duration:  M1 - M15 (15 months) 

The aim of Work Package 5 is to develop user-focused standards of care (SOC) for rheumatoid arthritis (RA) and osteoarthritis (OA)based on existing Clinical Practice Guidelines (CPGs) and expert consensus. 

Work Package 5 is based in Vienna, Austria and is led by Tanja Stamm and Josef Smolen. The team in Vienna consists further of Michaela Stoffer who is the project coordinator. Work package 5 links directly to the development of Health Care Quality Indicators (Work Package 6) that will measure the standards of care and is based in Lund, Sweden. Currently, the final version of the SOC for RA and OA are being prepared.

The team started off last year by conducting a systematic review of the international documents covering guidelines and recommendations for RA and OA. Expert organisationsin Europe (scientific, health professionals and social/ patient leagues) were contacted and asked to provide documents concerning the management and care of osteoarthritis (OA). This included recommendations, guidelines, Standards of Care, consensus statements and similar papers. In total, 80 societies in 45 countries were contacted. In addition to the data gained from these experts, a systematic literature search was conducted in Medline, CINAHL and the Internet from 05/2010 till 08/2010. The reference list of the retrieved documents were reviewed for other possible documents which may have not been found through the other strategies.

The spectrum of the documents found were very broad and ranged from the very elaborate to the complete absence of clinical practice guidelines. Additionally, the format of documents varied widely: guidelines were received in the form of published articles, as well as documents with several hundred pages. By using the AGREE checklist (www.agreetrust.org) the methodological quality of the retrieved guidelines were assessed to ensure that only those of a high quality were included and the management aspects were extracted. In order to analyse and group these management recommendations, two meetings were organised in Vienna.

OA was addressed in the first meeting (September 2010). Sixteen eumusc.net researchers and patient representatives from various European countries (Austria, France, Norway, Poland, Romania, Slovenia, Spain, Sweden, and United Kingdom) were present. RA was addressed in a second meeting (February 2011) with participation of 21 international experts and patient representatives (from Austria, France, Netherlands, Norway, Poland, Romania, Slovenia, Spain, Sweden, and United Kingdom). After the meetings, a draft of the formulation of the SOC items for RA and OA were sent to all the working group participants to obtain more ideas and comments of the experts. At present the suggestions for improvement of SOC are synthesized and a final draft is in preparation. For the time being you can download the draft version of the report.

The SOC will be available in a professional version and a lay version - to enable people with OA or RA to clarify if they have enough information about their condition and treatment. The lay version of the user-focused SOC for OA will be disseminated in all 23 official language of the European Union for the information of people with OA across all member states.  This work will contribute to the harmonization of RA and OA treatment in Europe.