title: Using an electronic platform interactively to improve treatment outcome in patients with rheumatoid arthritis: new developments from the DANBIO registry.
abstract: Electronic platforms have been developed to help the clinician monitor disease activity in rheumatoid arthritis (RA) to support at treat-to-target strategy. We present an initiative to interactively improve disease control in patients with rheumatoid arthritis.
  
  
  
  In patients who presented with one or more swollen joints AND moderate/high disease activity (i.e. either CDAI≥10.1 and/or DAS-28CRP>3.2, which is automatically calculated in the DANBIO registry), a red alert was shown, which activated a pop-up: "This patient has at least one swollen joint AND either CDAI≥ 10.1 or DAS28CRP>3.2. Which action do you as a physician take today: □ Intensify treatment, □ Treatment intensification is not possible currently/awaiting results of additional investigations, □ No further treatment intensification is possible, □ The patient does not want to intensify treatment, □ Other decisions taken" RESULTS: Of 21,056 patients with RA, 40% fulfilled the criteria for getting the alert message. The pop-up was activated and completed by the physician in 65% of those (5,428 patients). Treatment was intensified in 67%. In 2% of patients, no additional treatment intensification was possible, and 8% of the patients objected to intensification.
  
  
  
  In >8,000 RA patients who presented with objective signs of active disease in routine care, an interactive feature of the DANBIO registry was introduced, which prompted the physician to take action and consider treatment intensification. In two-thirds of the cases, the treating physician reported that treatment was intensified.
authors.affiliation: DANBIO Registry & Copenhagen Center for Arthritis Research, Center for Rheumatology & Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet; and Dept.of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Merete L
authors.initials: ML
authors.lastname: Hetland
authors.affiliation: Zitelab ApS, Frederiksberg, Denmark.
authors.forename: Niels Steen
authors.initials: NS
authors.lastname: Krogh
authors.affiliation: King Christian X's Hospital for Rheumatic Diseases, Gråsten, and University of Southern Denmark, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Hørslev-Petersen
authors.affiliation: Sygehus Lillebælt, Region Syddanmark, Denmark.
authors.forename: Berit
authors.initials: B
authors.lastname: Schiøttz-Christensen
authors.affiliation: DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark.
authors.forename: Inge Juul
authors.initials: IJ
authors.lastname: Sørensen
authors.affiliation: DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup; and Department of Rheumatology, Herlev and Gentofte University Hospital, Hellerup, Denmark.
authors.forename: Jensen
authors.initials: J
authors.lastname: Dorte Vendelbo
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D003718:Denmark; D004360:Drug Therapy, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012042:Registries; D017010:Reminder Systems; D012219:Rheumatology / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents