Is your institution ready to be certified in the management of Spondyloarthritis?

 

PANLAR, through the REAL-PANLAR group, invites health institutions in Latin America to apply for certification as a Center of Excellence in Spondyloarthritis (SpA). This accreditation recognizes centers that provide comprehensive, interdisciplinary, and high-quality care in the management of this rheumatic disease.

 

Types and requirements for Centers of Excellence in Axial Spondyloarthritis

Three types of Centers of Excellence (CoE) have been established: Standard, Optimal, and Model, defined according to resource availability and care standards.

Human resources criteria highlighted the importance of multidisciplinary teams including rheumatologists, physiatrists, and dermatologists, with agreement rates ranging from 70.6% to 100%.

Structural requirements, such as electronic health systems for traceability and continuous training, reached consensus levels between 81.3% and 100%.

Process-related criteria emphasized integrated care models, the implementation of the treat-to-target (T2T) strategy, and the use of validated clinimetric tools (e.g., ASDAS, BASDAI).

A framework was established defining three types of Centers of Excellence (CoE) for the care of patients with axial spondyloarthritis (axSpA), categorized according to the level of resources available and the standards of care:

•    Standard CoE: Represents the basic level, with the minimum resources necessary to provide care for patients with axSpA.
•    Optimal CoE: Includes additional resources and a more comprehensive approach to improve the quality of care.
•    Model CoE: Constitutes the most advanced level, with access to complete multidisciplinary teams and highly specialized processes.

 

Structure

Human resources: The criteria define the professional profiles required for each CoE level. In the Model CoE, a full multidisciplinary team is required, including 2–3 rheumatologists, physiatrists, dermatologists, gastroenterologists, ophthalmologists, orthopedists, psychologists, physiotherapists, occupational therapists, among others.

At the Optimal and Model levels, care must be comprehensive and multidisciplinary, following accepted clinical guidelines for both pharmacological and non-pharmacological treatments.

Infrastructure:

•    Continuous training: Emphasizes the importance of training the medical team to improve early identification of axSpA and enhance the quality of care.
•    Physical infrastructure: Centers must guarantee adequate facilities, equipment, supplies, and necessary medications.
•    Information systems: An electronic system is required to ensure traceability, data security, and periodic evaluation of care.

 

Processes

The processes established for CoEs in axial spondyloarthritis (axSpA) focus on implementing standardized, evidence-based care strategies.

•    Care model: CoEs must have documented protocols, care models, or standardized processes to ensure consistency and adherence to best practices. The model must be comprehensive and multidisciplinary, integrating key therapeutic aspects to optimize clinical outcomes. It should also improve accessibility and enable early diagnosis to reduce disease burden.
•    Treatment: Adoption of the Treat-to-Target (T2T) strategy is recommended as the optimal approach for effective disease control in axSpA, ensuring continuous evaluations and treatment adjustments according to disease activity.
•    Clinical follow-up: Regular monitoring is recommended using validated assessment tools such as ASDAS, BASDAI, BASFI, and DAPSA, depending on whether axSpA is axial or peripheral. This ensures an objective evaluation of disease progression and treatment effectiveness.

 

Outcomes

The outcome criteria focus on evaluating CoE effectiveness through continuous monitoring and quality improvement measures.

•    Monitoring: CoEs must systematically record disease activity using standardized clinimetric tools to ensure accurate assessments and optimal management.
•    Timeliness of care: Efficiency must be evaluated in terms of time from referral to diagnosis and initiation of treatment, favoring early intervention.
•    Continuous improvement: Regular activities must be carried out to strengthen quality, including the creation of multidisciplinary committees and communication mechanisms that optimize resource utilization.
•    Knowledge production: CoEs must systematically analyze and publish collected data to contribute to research, generate new knowledge, and develop educational materials that strengthen axSpA management.

Download the necessary documents to begin the process here: