National recognition for Gateshead rheumatology unit The Department of Rheumatology at the Queen Elizabeth Hospital, Gateshead has been named runner up in the prestigious, national Innovation in Rheumatology Awards, which highlights examples of innovation and excellence that have benefited patients with rheumatic disease.
Dr Clive Kelly, head of the department of rheumatology at the Queen Elizabeth Hospital, has led a team of consultants and nurse specialists in studies into the clinical relevance of lung involvement in rheumatoid arthritis. He says: “I’m delighted at the recognition we’ve gained, which reflects the hard work and dedication of the entire rheumatology team. This study has presented some interesting conclusions relating to clinical practice which should benefit many patients as a result.”
Data collected during the study highlighted both the frequency of pneumonia in Rheumatoid Arthritis (RA) and the relatively high death rate resulting from it (twice that seen in patients without RA). The study also vindicates the use of disease modifying anti rheumatic drugs (DMARDs) such as Methotrexate although it does show a link between oral steroid use and lung infection.
A study of 1522 patients with RA from the Gateshead area undertaken over a 12 month period confirmed a high incidence of pneumonia in RA and also demonstrated a relatively high mortality rate when compared to community acquired pneumonia in patients without rheumatism. Risk factors for admission with pneumonia included taking oral steroids and not being on DMARDs. Older patients and those with underlying heart or lung disease were also at increased risk.
A number of areas for change in clinical practice were recommended as a result. These included the early introduction of DMARDs in all patients, together with a prompt and more extensive use of vaccination against both influenza and pneumococcus, which are the two most frequent infections implicated in the development of acute lung problems in rheumatoid arthritis patients.
As a consequence of these findings, changes have been made to clinical practice in Gateshead. DMARDs are initiated early in all RA patients and the unit actively encourages annual vaccination against influenza and five yearly pneumovax injections in all patients independent of their treatment. Older patients with long disease duration are now encouraged to start DMARD therapy rather than oral steroids.
An audit has been taken of the annual uptake of vaccination against influenza and pneumococcus and there has been a significant increase in the uptake of vaccination amongst Gateshead RA patients. Early observations would suggest that the incidence of pneumonia in RA population has already decreased significantly as a result, but this will be formally assessed over the next 12 months.
Ian Renwick, Chief Executive of Gateshead Health NHS Foundation Trust said: “The department of rheumatology in Gateshead has a growing reputation for undertaking clinical research and audit projects designed to inform and influence clinical practice.
The Innovation in Rheumatology Awards acknowledges research that makes a real difference to the treatment and care of patients and it’s a great accolade to Dr Kelly and his team that the department of rheumatology at the Queen Elizabeth Hospital has received this recognition.”
Media contact: Kate Slater, Persuasion PR, 0191 214 0222,
Kate Slater
kate.slater@persuasion-pr.com
