title: Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative.
abstract: In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.
authors.affiliation: Department of Rheumatology, Université Joseph Fourier, GREPI-CNRS, Grenoble Hospital, France.
authors.forename: Athan
authors.initials: A
authors.lastname: Baillet
authors.affiliation: Department of Rheumatology, Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.affiliation: Instituto de Salud Musculoesquelética, Madrid, Spain.
authors.forename: Loreto
authors.initials: L
authors.lastname: Carmona
authors.affiliation: EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
authors.forename: Maarten de
authors.initials: Md
authors.lastname: Wit
authors.affiliation: Integrated Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: van Eijk-Hustings
authors.affiliation: EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Bertheussen
authors.affiliation: Salisbury NHS Foundation Trust Hospital, Salisbury, UK.
authors.forename: Kent
authors.initials: K
authors.lastname: Alison
authors.affiliation: EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.
authors.forename: Mette
authors.initials: M
authors.lastname: Toft
authors.affiliation: Cyprus League Against Rheumatism, Cyprus, Nikosia, Cyprus.
authors.forename: Marios
authors.initials: M
authors.lastname: Kouloumas
authors.affiliation: Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra; Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal.
authors.forename: Ricardo J O
authors.initials: RJ
authors.lastname: Ferreira
authors.affiliation: Independent Nurse Consultant, North Devon, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Oliver
authors.affiliation: Department of Internal Medicine, University of Cologne, Cologne, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rubbert-Roth
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sander
authors.initials: S
authors.lastname: van Assen
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
authors.forename: William G
authors.identifier: http://orcid.org/0000-0001-5881-4857
authors.initials: WG
authors.lastname: Dixon
authors.affiliation: Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Finckh
authors.affiliation: Epidemiology Unit, German Rheumatism Research Centre, and Rheumatology, Charité, University Medicine, Berlin, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Zink
authors.affiliation: Albany Medical College and The Center for Rheumatology, Albany, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Kremer
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Amsterdam Rheumatology immunology Center | VUmc and Reade, The Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Nurmohamed
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, The Netherlands.
authors.forename: Desirée
authors.identifier: http://orcid.org/0000-0002-5781-158X
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Department of Rheumatology, Paris Descartes University-Hôpital Cochin. Assistance Publique-Hôpitaux de Paris. INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D015897:Comorbidity; D032921:Consensus; D003863:Depression / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000517:prevention & control; D006801:Humans; D007511:Ischemia / Q000517:prevention & control; D009369:Neoplasms / Q000517:prevention & control; D010024:Osteoporosis / Q000517:prevention & control; D012216:Rheumatic Diseases / Q000150:complications*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: Autoimmune Diseases; Cardiovascular Disease; Infections; Multidisciplinary team-care; Osteoporosis