Rheumatoid arthritis: its economic burden and health-related quality of life in Colombia and worldwide: A Scoping Review

Artritis reumatoide: carga económica y calidad de vida relacionada con la salud en Colombia y en el mundo: Revisión de alcance

Introduction: the rise in chronic diseases is one of the major threats to health and sustainability of care systems. To this end, risk adjustments allow the development of population classification programs which become instruments to implement care models based on morbidity, risk classification and cost, and for developing predictive models and analyzing per capita costs based on population characteristics, leading to achieve a better financial management.  As part of primary care, risk management should anticipate diseases for their early diagnosis and timely treatment, aimed at reducing their severity and sequelae. Some cause great costs for the health care system, affecting its balance and sustainability, such as, rheumatoid arthritis (RA), considered a high-cost disease, due to its impact and comorbidities. Objective: to review studies on economic burden (EB), burden of disease (BoD1), out-of-pocket expenses, catastrophic health expenditures (CHE) and health-related quality of life (HRQoL), in patients with RA in Colombia and worldwide, between 2010 and 2022. Methods: a scoping review of 482 articles, 139 on EB and BoD1, 14 on out-of-pocket expenses and CHE, and 329 on HRQoL, found in the indexed literature in the Scopus, Medline through Pubmed and JSTOR databases in English and Spanish. Results: a trend in the growth of the literature, was observed, with a predominance of reports on biological therapies, considering EB and BoD1 and HRQoL as well, followed by healthcare studies and systematic literature reviews (SLR). The United States leads this research, followed by the United Kingdom; the most used questionnaire to assess health-related quality of life was the SF-36 (41.9%) followed by the EQ- 5D (19%) and although the Qol–RA (Quality of Life in Rheumatoid Arthritis Scale) validated in Colombia is available, it is seldom used. Conclusions: the increase of studies on healthcare costs has gained great relevance for learning about reality and creating instructions on risk management, teach concepts, analyze impact scenarios, and study sensitivities, while showing all the possible results.

1. Vargas Beltrán DA. Análisis y definición de un modelo administrativo de gestión del riesgo en salud para el control del presupuesto máximo de recobro en la empresa Aliansalud EPS [Tesis Maestría]. Bogotá: Universidad EAN; 2021.
2. Population Division of the United Nations Department of Economic and Social Affair. World Population Prospects 2019: Summary of methodological updates introduced in the 2019 revision [Internet]. DESA; 2019 [Update 2023 Mar 8]; Available from: https://population.un.org/wpp/Publications/Files/WPP2019_Methodological-updates.pdf
3. Páez Nieto LV, González Reyes SD. Análisis de la gestión del riesgo en salud para la intervención de las enfermedades crónicas [Tesis]. Bogotá: Universidad Santo Tomás; 2018.
4. OECD. Health at a Glance 2021: OECD Indicators [Internet]. París: OECD Publishing [Internet]. OECD Publishing; 2021 [Citado 2023 Mar 8]. Disponible en: https://doi.org/10.1787/ae3016b9-en.
5. Superintendencia de Salud. Alcances Teóricos y Experiencia Internacional en Modelamiento del Gasto en Salud y Ajuste de Riesgos. Chile: Departamento de Estudios y Desarrollo; 2017.
6. Carnota Lauzán O. El crecimiento de los costos en salud visto desde la ineficiencia. Rev Cuba Salud Pública. 2017;43(4):586-609
7. Balsa A, Lojo-Oliveira L, Alperi-López M, García-Manrique M, Ordóñez-Cañizares C, Pérez L, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring in clinical practice: the spanish cohort of the COMORA study. Reumatol Clin. 2019;15(2):102-8. https://doi.org/10.1016/j.reuma.2017.06.002.
8. Díaz Cuña C, Consani S, Rostan S, Fernández L, Moreira E, Sanmartí R. Artritis reumatoide: manifestaciones extraarticulares y comorbilidades. Rev Colomb Reumatol. 2022;29(3):196-204. https://doi.org/10.1016/j.rcreu.2021.03.015.
9. Pabón-Porras MA, Molina-Ríos S, Flórez-Suárez JB, Coral-Alvarado PX, Méndez-Patarroyo P, Quintana-López G. Rheumatoid arthritis and systemic lupus erythematosus: Pathophysiological mechanisms related to innate immune system. SAGE Open Med. 2019;7:1-24. https://doi.org/10.1177/2050312119876146.
10. Fondo Colombiano de Enfermedades de Alto Costo. Situación de artritis en Colombia 2021. Bogotá: Fondo Colombiano de Enfermedades de Alto Costo; 2022.
11. Salazar-Mejía CE, Galarza-Delgado DÁ, Colunga-Pedraza IJ, Azpiri-López JR, Wah-Suárez M, Wimer-Castillo BO, et al. Relación entre productividad laboral y características clínicas de la artritis reumatoide. Reumatol Clínica. 2019;15(6):327-32. https://doi.org/10.1016/j.reuma.2017.12.006.
12. Cuervo FM, Santos AM, Peláez-Ballestas I, Rueda JC, Angarita JI, Giraldo R, et al. Comparison of quality of life in patients with musculoskeletal symptoms, those with other comorbidities, and healthy people, in a Colombian open population study. Rev Colomb Reumatol. 2020;27(3):166-76. https://doi.org/10.1016/j.rcreue.2020.04.002.
13. Rojas-Suarez MA, García-Ubaque JC, Rojas-Suarez MA, García-Ubaque JC. Gestión de riesgo para la prevención primaria de tuberculosis en una entidad administradora de planes de beneficios en salud en Colombia. Rev Salud Pública. 2021;23(6):1-6. https://doi.org/10.15446/rsap.v23n6.95857.
14. Solis Cartas U, Calvopiña Bejarano SJ. Comorbilidades y calidad de vida en Osteoartritis. Rev Cuba Reumatol. 2018;20(2):1-14. http://dx.doi.org/10.5281/zenodo.1188918.
15. Ministerio de Salud y Protección Social. Gestión integral del riesgo en salud. Perspectiva desde el aseguramiento en el contexto de la Política De Atención Integral En Salud [Internet]. Colombia: Ministerio de Salud y Protección Social; 2018 [Citado 2023 Mar 8]; Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VP/DOA/girs-prespectiva-desde-aseguramiento.pdf
16. Dall TM, Yang W, Gillespie K, Mocarski M, Byrne E, Cintina I, et al. The Economic Burden of Elevated Blood Glucose Levels in 2017: diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care. 2019;42(9):1661-8. http://dx.doi.org/10.2337/dc18-1226.
17. Organización Mundial de la Salud. Salvar vidas, reducir el gasto: una respuesta estratégica a las enfermedades no transmisibles [Internet]. Organización Mundial de la Salud; 2018 [Citado 2023 Mar 8]; Disponible en: https://apps.who.int/iris/bitstream/handle/10665/275408/WHO-NMH-NVI-18.8-spa.pdf?sequence=1&isAllowed=y
18. DANE. Caracterización de la pobreza monetaria y resultados clases sociales [Internet]. Colombia; 2021 [Citado 2023 Mar 8]; Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/pobreza-y-condiciones-de-vida/pobreza-monetaria/pobreza-monetaria-2020
19. Sarmiento-Bejarano H, Ramírez-Ramírez C, Carrasquilla-Sotomayor M, Alvis-Zakzuk NJ, Alvis-Guzmán N. Carga económica de la enfermedad renal crónica en Colombia, 2015-2016. Salud Uninorte. 2019;35(1):67-83. http://dx.doi.org/10.14482/sun.35.1.616.6.
20. Hidalgo-Troya A, Rodríguez JM, Rocha-Buelvas A, Urrego-Ricaurte D. Carga de enfermedad por COVID-19 en el departamento de Nariño, Colombia, 2020-2021. Rev Perú Med Exp Salud Pública. 2022;39(3):281-91. http://dx.doi.org/10.17843/rpmesp.2022.393.10947.
21. Montenegro Enriquez J. Propuesta de gestión de riesgos empresariales - El caso del COVID 19 [Tesis de Maestría]. Universidad Nacional de Colombia; 2020.
22. Wang J, Yang Z, Zheng Y, Peng Y, Wang Q, Xia H, et al. Effects of illness perceptions on health-related quality of life in patients with rheumatoid arthritis in China. Health Qual Life Outcomes. 2021;19(1):1-11. http://dx.doi.org/10.1186/s12955-021-01770-4.
23. Martinec R, Pinjatela R, Balen D. Quality Of Life In Patients With Rheumatoid Arthritis - A Preliminary Study. Acta Clin Croat. 2019;58(1):157-66. http://dx.doi.org/10.20471/acc.2019.58.01.20.
24. Naqvi AA, Hassali MA, Naqvi SBS, Aftab MT. Impact of pharmacist educational intervention on disease knowledge, rehabilitation and medication adherence, treatment-induced direct cost, health-related quality of life and satisfaction in patients with rheumatoid arthritis: study protocol for a randomized controlled trial. Trials. 2019;20(1):488. http://dx.doi.org/10.1186/s13063-019-3540-z.
25. Chambergo-Michilot D, Diaz-Barrera ME, Benites-Zapata VA. Revisiones de alcance, revisiones paraguas y síntesis enfocada en revisión de mapas: aspectos metodológicos y aplicaciones. Rev Peru Med Exp Salud Pública. 2021;38(1):136-42. https://doi.org/10.17843/rpmesp.2021.381.6501.
26. Fernández-Sánchez H, King K, Enríquez-Hernández CB. Scoping Reviews as a methodology for scientific knowledge synthesis. Enferm Univ. 2020;17(1):87-94. Autor para correspondencia. https://doi.org/10.22201/eneo.23958421e.2020.1.697.
27. Aromataris E MZ, editor. JBI Manual for Evidence Synthesis. JBI; 2020.
28. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850.
29. Ministerio de Ciencia y Tecnología. Modelo de clasificación de las revistas cientificas - Pubindex 2022 [Internet]. Colombia; 2022 [Citado 2023 Mar 8]; Disponible: https://scienti.minciencias.gov.co/publindex/#/noticias/lista
30. Fondo Colombiano de Enfermedades de Alto Costo. ¿Qué es la CAC? [Internet]. Colombia; 2022 [Citado 2023 Mar 8]. Disponible en: https://cuentadealtocosto.org/site/quienes-somos/