Changes in Treatments and Outcomes After Implementation of a National Universal Access Program for Juvenile Idiopathic Arthritis

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dc.catalogadorjca
dc.contributor.authorConcha, Sara
dc.contributor.authorMorales, Pamela S.
dc.contributor.authorTalesnik, Eduardo
dc.contributor.authorBorzutzky, Arturo
dc.date.accessioned2023-01-19T19:24:33Z
dc.date.available2023-01-19T19:24:33Z
dc.date.issued2021
dc.description.abstractObjective. To evaluate the clinical and demographic characteristics of patients with juvenile idiopathic arthritis (JIA) in Chile and compare treatments and outcomes before and after the introduction in 2010 of the Explicit Health Guarantees (GES) for JIA, a national universal access program for diagnosis and treatment of this condition. Methods. The clinical records of 280 patients with JIA followed at a private tertiary academic health network between 2007 and 2018 were reviewed. Results. Seventy percent of patients with JIA were female, mean age at diagnosis was 8.5 +/- 4.8 years and mean follow-up was 4.0 +/- 3.7 years. After GES implementation (post-GES), time to evaluation by pediatric rheumatologist and diagnostic delay were significantly reduced (15.0 +/- 4.5 vs 9.0 +/- 4.2 months, P = 0.004). In addition, use of magnetic resonance imaging significantly increased post-GES (P < 0.001). In terms of JIA treatments, before GES implementation, no patients received biologics. Of the 67 patients diagnosed before 2010 with continued follow-up at our center, 34% began biologic treatment after GES implementation. Of 196 patients diagnosed post-GES, 46% were treated with biologics. JIA remission rates were significantly higher in patients diagnosed post-GES compared to pre-GES (43% vs 29%, P = 0.02). Post-GES, we observed a significant decrease in uveitis complications among JIA patients (45% vs 13%, P = 0.04). Conclusion. The implementation of a national government-mandated universal access program for guaranteed JIA diagnosis and treatment led to earlier access to a pediatric rheumatologist and JIA diagnosis, increased rates of treatment with biologic drugs, higher rates of clinical remission, and lower rates of uveitis complications in Chilean children with JIA.
dc.fechaingreso.objetodigital2023-01-19
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.3899/jrheum.210011
dc.identifier.eissn1499-2752
dc.identifier.issn0315-162X
dc.identifier.pubmedidMEDLINE:33934075
dc.identifier.urihttps://doi.org/10.3899/jrheum.210011
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/66390
dc.identifier.wosidWOS:000714981500016
dc.information.autorucEscuela de Medicina; Borzutzky Schachter Arturo Jose; 0000-0002-7904-262X; 5897
dc.issue.numero11
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final1731
dc.pagina.inicio1725
dc.publisherJ RHEUMATOL PUBL CO
dc.revistaJOURNAL OF RHEUMATOLOGY
dc.rightsacceso abierto
dc.subjectBiologics
dc.subjectDelayed diagnosis
dc.subjectHealth policies
dc.subjectJuvenile idiopathic arthritis
dc.subjectUniversal healthcare
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleChanges in Treatments and Outcomes After Implementation of a National Universal Access Program for Juvenile Idiopathic Arthritis
dc.typeartículo
dc.volumen48
sipa.codpersvinculados5897
sipa.indexWoS
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