scholarly journals 2019 EULAR recommendations for the generic core competences of health professionals in rheumatology

2019 ◽  
Vol 79 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Lisa Edelaar ◽  
Elena Nikiphorou ◽  
George E Fragoulis ◽  
Annamaria Iagnocco ◽  
Catherine Haines ◽  
...  
Keyword(s):  
Health Professionals ◽  
Rating Scale ◽  
Physical Therapists ◽  
Task Force ◽  
National Level ◽  
Postgraduate Education ◽  
Specific Reference ◽  
Level Of Evidence ◽  
Eular Recommendations ◽  
Core Competences

Background/objectivesTo maintain and optimise the quality of care provided by health professionals in rheumatology (HPRs), adequate educational offerings are needed. This task force (TF) aimed to develop evidence-based recommendations for the generic core competences of HPRs, with specific reference to nurses, physical therapists (PTs) and occupational therapists (OTs) to serve as a basis for their postgraduate education.MethodsThe EULAR standardised operating procedures for the development of recommendations were followed. A TF including rheumatologists, nurses, PTs, OTs, patient-representatives, an educationalist, methodologists and researchers from 12 countries met twice. In the first TF meeting, 13 research questions were defined to support a systematic literature review (SLR). In the second meeting, the SLR evidence was discussed and recommendations formulated. Subsequently, level of evidence and strength of recommendation were assigned and level of agreement (LoA) determined (0–10 rating scale).ResultsThree overarching principles were identified and 10 recommendations were developed for the generic core competences of HPRs. The SLR included 79 full-text papers, 20 of which addressed the competences, knowledge, skills, attitudes and/or educational needs of HPRs from multiple professions. The average LoA for each recommendation ranged from 9.42 to 9.79. Consensus was reached both on a research and educational agenda.ConclusionEvidence and expert opinion informed a set of recommendations providing guidance on the generic core competences of HPRs. Implementation of these recommendations in the postgraduate education of HPRs at the international and national level is advised, considering variation in healthcare systems and professional roles.

scholarly journals Development of generic core competences of health professionals in rheumatology: a systematic literature review informing the 2019 EULAR recommendations

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001028
Author(s):  
George E Fragoulis ◽  
Lisa Edelaar ◽  
Theodora P M Vliet Vlieland ◽  
Annamaria Iagnocco ◽  
Valentin Sebastian Schäfer ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Health Professionals ◽  
Methodological Quality ◽  
National Level ◽  
Basic Knowledge ◽  
Eular Recommendations ◽  
Core Competences ◽  
Generic Competences

ObjectiveTo identify generic competences on the desired knowledge, skills and of health professionals in rheumatology (HPRs) to inform the respective EULAR recommendations.MethodsA systematic literature review was performed on the generic core competences (defined as knowledge, skills or attitudes) of HPRs (nurses, physical therapists (PTs) or occupational therapists (OTs)). Literature was obtained from electronic databases, published EULAR recommendations and via personal communication with representatives of national rheumatology societies and experts in the field. Qualitative, quantitative and mixed methods studies were included, and their methodological quality was scored using appropriate instruments.ResultsFrom 766 references reviewed, 79 fulfilled the inclusion criteria. Twenty studies addressed competences of multiple HPRs: 15 were of qualitative design, 1 quantitative, 1 mixed-methods, 2 systematic reviews and 1 opinion paper. The methodological quality of most studies was medium to high. Five studies concerned the development of a comprehensive set of competences. Key competences included: basic knowledge of rheumatic diseases, holistic approach to patient management, effective communication with colleagues and patients and provision of education to patients. The proposed competences were confirmed in studies focusing on one or more specific competences, on a rheumatic disease or on a specific profession (nurses, PTs or OTs).ConclusionGeneric competences were identified for HPRs. Data were mostly derived from qualitative studies. All identified studies varied and were at national level, highlighting the need for the harmonisation of HPR competences across Europe. These findings underpin the development of EULAR recommendations for the core competences of HPRs.

scholarly journals EULAR recommendations for intra-articular therapies

2021 ◽  
pp. annrheumdis-2021-220266
Author(s):  
Jacqueline Uson ◽  
Sebastián Cruz Rodriguez-García ◽  
Raul Castellanos-Moreira ◽  
Terence W O'Neill ◽  
Michael Doherty ◽  
...  
Keyword(s):  
Health Professionals ◽  
Task Force ◽  
Healthcare Providers ◽  
Local Anaesthetics ◽  
Adult Patients ◽  
Background Information ◽  
Level Of Evidence ◽  
Safety Issues ◽  
Eular Recommendations ◽  
Final Agreement

ObjectivesTo establish evidence-based recommendations to guide health professionals using intra-articular therapies (IAT) in adult patients with peripheral arthropathies.MethodsA multidisciplinary international task force established the objectives, users and scope and the need for background information, including systematic literature reviews) and two surveys addressed to healthcare providers and patients throughout Europe. The evidence was discussed in a face-to-face meeting, recommendations were formulated and subsequently voted for anonymously in a three-round Delphi process to obtain the final agreement. The level of evidence was assigned to each recommendation with the Oxford levels of evidence.ResultsRecommendations focus on practical aspects to guide health professionals before, during and after IAT in adult patients with peripheral arthropathies. Five overarching principles and 11 recommendations were established, addressing issues related to patient information, procedure and setting, accuracy, routine and special aseptic care, safety issues and precautions to be addressed in special populations, efficacy and safety of repeated joint injections, use of local anaesthetics and aftercare.ConclusionWe have developed the first evidence and expert opinion-based recommendations to guide health professionals using IAT. We hope that these recommendations will be included in different educational programmes, used by patient associations and put into practice via scientific societies to help improve uniformity and quality of care when performing IAT in peripheral adult joints.

scholarly journals 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

2019 ◽  
Vol 79 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Bianca Bech ◽  
Jette Primdahl ◽  
Astrid van Tubergen ◽  
Marieke Voshaar ◽  
Heidi A Zangi ◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Psychosocial Support ◽  
Task Force ◽  
Healthcare Team ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Chronic Inflammatory Arthritis ◽  
Eular Recommendations ◽  
Level Of Agreement

To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

scholarly journals 2018 update of the EULAR recommendations for the management of hand osteoarthritis

2018 ◽  
Vol 78 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Margreet Kloppenburg ◽  
Féline PB Kroon ◽  
Francisco J Blanco ◽  
Michael Doherty ◽  
Krysia S Dziedzic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Expert Opinion ◽  
Task Force ◽  
Treatment Options ◽  
Symptom Relief ◽  
Information Provision ◽  
Hand Osteoarthritis ◽  
Level Of Evidence ◽  
Eular Recommendations ◽  
Systemic Treatments

Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options for hand OA published to date. Based on the evidence and expert opinion from an international task force of 19 physicians, healthcare professionals and patients from 10 European countries formulated overarching principles and recommendations. Level of evidence, grade of recommendation and level of agreement were allocated to each statement. Five overarching principles and 10 recommendations were agreed on. The overarching principles cover treatment goals, information provision, individualisation of treatment, shared decision-making and the need to consider multidisciplinary and multimodal (non-pharmacological, pharmacological, surgical) treatment approaches. Recommendations 1–3 cover different non-pharmacological treatment options (education, assistive devices, exercises and orthoses). Recommendations 4–8 describe the role of different pharmacological treatments, including topical treatments (preferred over systemic treatments, topical non-steroidal anti-inflammatory drugs (NSAIDs) being first-line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date guidance on the management of hand OA, based on expert opinion and research evidence.

scholarly journals EULAR recommendations for patient education for people with inflammatory arthritis

2015 ◽  
Vol 74 (6) ◽  
pp. 954-962 ◽  
Author(s):  
Heidi A Zangi ◽  
Mwidimi Ndosi ◽  
Jo Adams ◽  
Lena Andersen ◽  
Christina Bode ◽  
...  
Keyword(s):  
Patient Education ◽  
Health Professionals ◽  
Inflammatory Arthritis ◽  
Research Agenda ◽  
Task Force ◽  
Evidence Based ◽  
Expert Opinions ◽  
Eular Recommendations ◽  
High Level ◽  
Educational Agenda

ObjectivesThe task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals’ educational needs in order to provide evidence-based PE.MethodsA multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement).ResultsBased on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4–9.8). The task force proposed a research agenda and an educational agenda.ConclusionsThe eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.

Is Dry Needling Applied by Physical Therapists Effective for Pain in Musculoskeletal Conditions? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 101 (3) ◽  
Author(s):  
Jorge Sánchez-Infante ◽  
Marcos J Navarro-Santana ◽  
Alfredo Bravo-Sánchez ◽  
Fernando Jiménez-Diaz ◽  
Javier Abián-Vicén
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Physical Therapists ◽  
Meta Analysis ◽  
Trigger Points ◽  
Body Region ◽  
Dry Needling ◽  
Level Of Evidence ◽  
Myofascial Trigger Points ◽  
Moderate Effect

Abstract Objective The main objective of this systematic review and meta-analysis was to determine the short-, medium-, and long-term effectiveness of dry needling (DN) applied by physical therapists to myofascial trigger points for the treatment of pain. Methods PubMed, Scopus, SportDiscus, and Web of Science databases were searched from their inception to February 2020. Randomized controlled trials that compared DN with other treatments or placebo and measured pain with a visual analog Scale or another numerical pain rating scale were included. Two authors used a personalized form to collect the following data relevant to the objectives of the review from each article independently: study design, purpose, sample size, diagnosis, characteristics of DN intervention, characteristics of placebo intervention, outcome measures, period of assessment, body region, DN technique, and number of sessions. The initial search identified 1771 articles. After the selection, 102 articles were assessed for eligibility; 42 of these articles measuring pain were used for the meta-analysis. Four meta-analyses were performed according to the follow-up period from the last reported treatment. Results This meta-analysis found a large effect to decrease pain within 72 hours (standardized mean difference [SMD] = −0.81; 95% CI = −1.21 to −0.40), a moderate effect in 1 to 3 weeks (SMD = −0.69; 95% CI = −1.02 to −0.35), a large effect in 4 to 12 weeks (SMD = −0.85; 95% CI = −1.30 to −0.40), and a large effect in 13 to 24 weeks (SMD = −0.81; 95% CI = −1.64 to −0.03). The risk of bias was generally low; however, the heterogeneity of the results downgraded the level of evidence. Conclusions Low-quality evidence that the immediate to 72-hour (large) effect, 4- to 12-week (large) effect, 13- to 24-week (large) effect, and moderate-quality 1- to 3-week (moderate) effect suggested that DN performed by physical therapists was more effective than no treatment, sham DN, and other therapies for reducing pain. Impact DN is commonly used by physical therapists to treat musculoskeletal pain, and it is very important for physical therapists to know the clinical conditions and time periods for which DN is effective in reducing pain in their patients.

scholarly journals EULAR recommendations for vaccination in paediatric patients with rheumatic diseases

2011 ◽  
Vol 70 (10) ◽  
pp. 1704-1712 ◽  
Author(s):  
M W Heijstek ◽  
L M Ott de Bruin ◽  
M Bijl ◽  
R Borrow ◽  
F van der Klis ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Task Force ◽  
Guideline Development ◽  
Scoring Systems ◽  
Level Of Evidence ◽  
Eular Recommendations ◽  
American College Of Rheumatology ◽  
Paediatric Patients ◽  
Prevention Of Infections

Evidence-based recommendations for vaccination of paediatric patients with rheumatic diseases (PaedRD) were developed by following the EULAR standardised procedures for guideline development. The EULAR task force consisted of (paediatric) rheumatologists/immunologists, one expert in vaccine evaluation, one expert in public health and infectious disease control, and one epidemiologist. A systematic literature review was conducted in MEDLINE, EMBASE, and abstracts of the EULAR and American College of Rheumatology meetings of 2008/9. The level of evidence and strength of recommendation were based on customary scoring systems. Delphi voting was applied to assess the level of agreement between task force members. 107 papers and eight abstracts were used. The majority of papers considered seasonal influenza (41) or pneumococcal (23) vaccination. 26 studies were performed specifically in paediatric patients, and the majority in adult rheumatoid arthritis and systemic lupus erythematosus patients. Fifteen recommendations were developed with an overall agreement of 91.7%. More research is needed on the safety and immunogenicity of (live-attenuated) vaccination in PaedRD, particularly in those using biologicals, and the effect of vaccination on prevention of infections.

scholarly journals 2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older

2020 ◽  
Vol 80 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Jo Adams ◽  
Nicky Wilson ◽  
Emalie Hurkmans ◽  
Margot Bakkers ◽  
Petra Balážová ◽  
...  
Keyword(s):  
Health Professionals ◽  
Task Force ◽  
Scientific Evidence ◽  
Fragility Fractures ◽  
Models Of Care ◽  
Level Of Evidence ◽  
Nutritional Interventions ◽  
Physician Health ◽  
The Mean ◽  
Level Of Agreement

ObjectiveTo establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older.MethodsPoints to consider were developed in accordance with EULAR standard operating procedures for EULAR-endorsed recommendations, led by an international multidisciplinary task force, including patient research partners and different health professionals from 10 European countries. Level of evidence and strength of recommendation were determined for each point to consider, and the mean level of agreement among the task force members was calculated.ResultsTwo overarching principles and seven points to consider were formulated based on scientific evidence and the expert opinion of the task force. The two overarching principles focus on shared decisions between patients and non-physician health professionals and involvement of different non-physician health professionals in prevention and management of fragility fractures. Four points to consider relate to prevention: identification of patients at risk of fracture, fall risk evaluation, multicomponent interventions to prevent primary fracture and discouragement of smoking and overuse of alcohol. The remaining three focus on management of fragility fractures: exercise and nutritional interventions, the organisation and coordination of multidisciplinary services for post-fracture models of care and adherence to anti-osteoporosis medicines. The mean level of agreement among the task force for the overarching principles and the points to consider ranged between 8.4 and 9.6.ConclusionThese first EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older serve to guide healthcare practice and education.

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