1. ‘Arthritis’ nomenclature in the daily practice Luc De Clercq, MD

2. Nomenclature for Arthritis Care The K55 nomenclature offers broad perspectives for new initiatives Diversification; individually adaptable Direct correlation between amount of provided care and financial support But also with direct, new responsibilities –Financial support must finally lead to better care for the patient with arthritis

3. K55 Arthritis Nomenclature Publication B.S. / M.B.: 04-12-08 Applicable: 01-02-09 K55 ; Art. 20 § 1 g (= rheumatology) 478030 (amb.) – 478041 (hosp.) Honorary: 61,77 euro (100% reimbursement for all categories) Max: 2 x / year (cum. with consultation)

4. K55 Arthritis Nomenclature Standaardevaluatie van het actief ziekteproces, de evolutie en de prognose, door de geaccrediteerde geneesheer-specialist voor reumatologie, bij een patiënt met chronisch inflammatoir reumatisch lijden, met behandelingsplan en schriftelijk verslag aan de huisarts’ Evaluation standard par le médecin spécialiste en rhumatologie accrédité du processus actif de la maladie, de l'évolution et du pronostic, chez un patient avec une pathologie inflammatoire rhumatoïde, avec plan de traitement et rapport écrit au généraliste

5. K55 Arthritis Nomenclature Patients with –Rheumatoid Arthritis (RA) –Ankylosing Spondylitis (AS) –Psoriatic Arthritis (PsA) DMARD and / or Biological treatment ‘Standard-evaluation’  Patient File Report to generalist

6. K55 Arthritis Nomenclature Standard evaluation consists of : –Specific Assessment > Care provider > Patient –Global interpretation – ‘reflection’ Confrontation with other findings (Biology, X ray, US, ….) Disease Activity, Evolution, Prognosis Analysis / Definition / Refining of therapeutic plan

7. K55 Arthritis Nomenclature Specific Assessment: –For RA: DAS 28 + HAQ –For AS BASFI + BASDAI –For PsA PsARC + HAQ (poly) / NRS scale (pauci)

8. PsARC : Psoriatic Arthritis Response Criteria Physician’s global assessment (0-5) Patient’s global self-assessment (0-5) Joint tenderness Joint swelling You will obtain a ‘set’ of 4 ‘results’. You will not have a ‘composite’ score

9. PsARC : Psoriatic Arthritis Response Criteria Treatment response = Improvement in at least 2 of 4 criteria –one must be joint tenderness or swelling –with no worsening in the others 1 and 2 : –improvement decrease > 1 unit –worsening increase > 1 unit 3 and 4 : –improvement decrease > 30% –worsening increase > 30 %

10. BASFI

11. DAS 28 DAS 28 = 0,56*√(TJC28)+ 0,28*√(SJC28)+ 0,7*LN(ESR)+ 0,014*VAS GA Patient

12. We look forwards ….