To report the long-term experience of a rheumatologist consultant “in situ” (RCI) in a primary care centre (PCC).
Material and methodsObservational retrospective study analysing the complete cohort of the patients seen by the RCI between 2013 and 2019. Rheumatology patients’ clinical characteristics and course of care were collected to estimate the diagnoses that were most likely to be monitored by a primary care physician (PCP).
ResultsA total of 876 consultations were attended; 205 were men (23.4%) and 671 women (76.6%).Most of the consultations (280, 33.2%) were diagnostic. On 167 occasions (19.8%) therapeutic issues were analysed; in 47 (5.6%) therapeutic infiltrations were performed. Chronic patient control was applied in 163 subjects (19.3%). A request for tests not available to the PCP was the reason for the consultation in 154 situations (18.3%). The profile most likely to continue being monitored in the PCC is the patient with osteoarthritis (OR = .13, CI 95%: .02–.67), soft tissue rheumatism (OR = .006, 95% CI: .01–.45) or cervical disc herniation (OR = .13, 95% CI: .02–.66). Less likely to be monitored by PCP after being seen by the RCI were subjects with rheumatoid arthritis (OR = .03, 95% CI: .00–.24), other inflammatory arthropathies (OR = .36, 95% CI: .16–.80) or with polymyalgia rheumatica (OR = .19, 95% CI: .06-.64 ), and those in need of chronic disease monitoring (OR = .16, 95% CI: .07–.34).
ConclusionsThe RCI makes it easier for the PCP to monitor patients with osteoarthritis, soft tissue rheumatism and cervical disc pathology.
Estudiar la utilidad a largo plazo de un reumatólogo consultor “in situ” (RCI) en un centro de Salud (CS).
Material y métodosEstudio observacional retrospectivo sobre la cohorte completa de pacientes atendidos entre 2013 y 2019, analizando variables clínicas y de curso asistencial, intentando perfilar qué diagnósticos de los pacientes reumáticos tenían más probabilidades de continuar su atención en el CS por el médico de Atención Primaria (MAP).
ResultadosSe atendieron 876 consultas; 205 (23,4%), varones y 671 (76,6%), mujeres; edad media: 64,1 años (DE = 16,6). La mayoría de las consultas (280, 33,2%) fueron diagnósticas. En 167 ocasiones (19,8%) se abordaron temas terapéuticos; en 47 (5,6%) se realizaron infiltraciones. La petición de pruebas no disponibles para el MAP se verificó en 154 situaciones (18,3%). El perfil de paciente con más opciones de continuar su seguimiento por el MAP en el CS es el portador de artrosis (OR = 0,13, IC 95%: 0,02–0,67), reumatismo de partes blandas (OR = 0,06, IC 95%: 0.01–0.45) o hernia discal cervical (OR = 0,13, IC 95%: 0,02–0,66 ). Los pacientes con menos probabilidades de seguimiento por MAP tras su paso por RCI son los portadores de artritis reumatoide (OR = 0,03, IC 95%: 0,00–0,24 ), otras artropatías inflamatorias (OR = 0,36, CI 95%: 0,16–0,80) o con polimialgia reumática (OR = 0,19, IC 95%:0,06–0,64); también los que necesitan de control de enfermo crónico (OR = 0,16, IC 95%: 0,07–0,34).
ConclusionesEl RCI facilita el seguimiento por el MAP de la artrosis, reumatismos de partes blandas y de la dicopatía cervical; le permite disponer de determinadas pruebas complementarias para el diagnóstico.