Screening to Prevent Multimorbidity in Rheumatic Patients Save

A population based screening program of patients with chronic inflammatory rheumatic diseases (IRD) demonstrates that systematic screening IRD patients for multimorbidity increased preventive interventions and reduced hospital admissions. 

IRD patients were identified a French national health database and matched with controls. The analysis looked at those screened or not and then a propensity score matching compared outcomes between exposed patients and controls. The primary endpoint was the dispensation of multimorbidity-preventing drugs, including vaccines, lipid-lowering agents, antiosteoporotic medications and antiplatelet drugs, in the year following the screening date. 

The cohorts included 286 exposed (screened) patients and 858 controls. The exposed patients had a 60% greater odds of meeting the composite endpoint of receiving multimorbidity preventing drugs (adjusted OR=1.6 (1.2–2.2), p<0.01). This still persisted after propensity score matching (55% vs 44%; OR=1.5; p=0.015), with increased utilisation of vaccines, cholesterol-lowering drugs and antiosteoporotic medications. 

Overall, there were fewer emergency admissions and hospitalisations (fracture, cardiovascular events or infection)in the exposed group (7.1% vs 15.3%; OR=0.42, p<0.01), with fewer severe infections (0.7% vs 3.9%; p=0.03). 

Systematic screening and prevention of multimorbidity in IRD is justified, evidence by a 50% rise in dispensation of multimorbidity-preventing drugs and a 58% drop in urgent hospitalisations and hospitalisations.