scholarly journals 2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice

2020 ◽  
pp. annrheumdis-2020-218986
Author(s):  
Valentin Ritschl ◽  
Tanja A Stamm ◽  
Daniel Aletaha ◽  
Johannes W J Bijlsma ◽  
Peter Böhm ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Structural Barriers ◽  
Adherence To Treatment ◽  
Patient Representatives ◽  
Screening Assessment ◽  
Free Environment ◽  
Level Of Agreement

BackgroundNon-adherence to treatment could preclude reaching an optimal outcome. Thirty to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to the agreed treatment.ObjectivesThe objective was to establish points to consider (PtCs) for the prevention, screening, assessment and management of non-adherence to (non-)pharmacological treatments in people with RMDs.MethodsAn EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included healthcare providers (HCPs), comprising rheumatologists, nurses, pharmacists, psychologists, physiotherapists, occupational therapists and patient-representatives from 12 European countries. A review of systematic reviews was conducted in advance to support the TF in formulating the PtCs. The level of agreement among the TF was established by anonymous online voting.ResultsFour overarching principles and nine PtCs were formulated. The PtCs reflect the phases of action on non-adherence. HCPs should assess and discuss adherence with patients on a regular basis and support patients to treatment adherence. As adherence is an agreed behaviour, the treatment has to be tailored to the patients’ needs. The level of agreement ranged from 9.5 to 9.9 out of 10.ConclusionsThese PtCs can help HCPs to support people with RMDs to be more adherent to the agreed treatment plan. The basic scheme being prevent non-adherence by bonding with the patient and building trust, overcoming structural barriers, assessing in a blame-free environment and tailoring the solution to the problem.

scholarly journals 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

2018 ◽  
Vol 77 (9) ◽  
pp. 1251-1260 ◽  
Author(s):  
Anne-Kathrin Rausch Osthoff ◽  
Karin Niedermann ◽  
Jürgen Braun ◽  
Jo Adams ◽  
Nina Brodin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inflammatory Arthritis ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
The Public ◽  
Knee Oa ◽  
Eular Recommendations ◽  
Patient Representatives ◽  
Research And Education ◽  
Level Of Agreement

Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.

scholarly journals EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001014 ◽  
Author(s):  
Aurélie Najm ◽  
Elena Nikiphorou ◽  
Marie Kostine ◽  
Christophe Richez ◽  
John D Pauling ◽  
...  
Keyword(s):  
Mobile Health ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Cost Benefit ◽  
Self Management ◽  
Mobile Health Applications ◽  
Development Evaluation ◽  
Level Of Agreement ◽  
Health Applications

BackgroundMobile health applications (apps) are available to enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health. However, guidance on the development and evaluation of such apps is lacking.ObjectivesThe objective of this EULAR task force was to establish points to consider (PtC) for the development, evaluation and implementation of apps for self-management of RMDs.MethodsA systematic literature review of app content and development strategies was conducted, followed by patient focus group and an online survey. Based on this information and along with task force expert opinion, PtC were formulated in a face-to-face meeting by a multidisciplinary task force panel of experts, including two patient research partners. The level of agreement among the panel in regard to each PtC was established by anonymous online voting.ResultsThree overarching principles and 10 PtC were formulated. Three PtC are related to patient safety, considered as a critical issue by the panel. Three are related to relevance of the content and functionalities. The requirement for transparency around app development and funding sources, along with involvement of relevant health professionals, were also raised. Ease of app access across ages and abilities was highlighted, in addition to considering the cost benefit of apps from the outset. The level of agreement was from 8.8 to 9.9 out of 10.ConclusionThese EULAR PtC provide guidance on important aspects that should be considered for the development, evaluation and implementation of existing and new apps.

scholarly journals 2019 EULAR points to consider for the assessment of competences in rheumatology specialty training

2020 ◽  
Vol 80 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Francisca Sivera ◽  
Alessia Alunno ◽  
Aurélie Najm ◽  
Tadej Avcin ◽  
Xenofon Baraliakos ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Training Programme ◽  
Assessment Practices ◽  
Specialty Training ◽  
Sufficient Time ◽  
Effective Implementation ◽  
European League Against Rheumatism ◽  
Training Programmes ◽  
Level Of Agreement

Background and aimStriving for harmonisation of specialty training and excellence of care in rheumatology, the European League Against Rheumatism (EULAR) established a task force to develop points to consider (PtCs) for the assessment of competences during rheumatology specialty training.MethodsA systematic literature review on the performance of methods for the assessment of competences in rheumatology specialty training was conducted. This was followed by focus groups in five selected countries to gather information on assessment practices and priorities. Combining the collected evidence with expert opinion, the PtCs were formulated by the multidisciplinary task force, including rheumatologists, medical educationalists, and people with rheumatic and musculoskeletal diseases. The level of agreement (LoA) for each PtC was anonymously voted online.ResultsFour overarching principles and 10 PtCs were formulated. The overarching principles highlighted the importance of assessments being closely linked to the rheumatology training programme and protecting sufficient time and resources to ensure effective implementation. In the PtCs, two were related to overall assessment strategy (PtCs 1 and 5); three focused on formative assessment and portfolio (PtCs 2–4); three focused on the assessment of knowledge, skills or professionalism (PtCs 6–8); one focused on trainees at risk of failure (PtC 9); and one focused on training the trainers (PtC 10). The LoA (0–10) ranged from 8.75 to 9.9.ConclusionThese EULAR PtCs provide European guidance on assessment methods throughout rheumatology training programmes. These can be used to benchmark current practices and to develop future strategies, thereby fostering continuous improvement in rheumatology learning and, ultimately, in patient care.

scholarly journals EULAR Points to Consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs)

2021 ◽  
pp. annrheumdis-2021-221261
Author(s):  
Christian Dejaco ◽  
Pedro M Machado ◽  
Francesco Carubbi ◽  
Philipp Bosch ◽  
Lene Terslev ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Healthcare Professionals ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Fusion Imaging ◽  
Imaging Modalities ◽  
Imaging Method ◽  
Sacroiliac Joints ◽  
Level Of Agreement

ObjectivesTo develop evidence-based Points to Consider (PtC) for the use of imaging modalities to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs).MethodsEuropean Alliance of Associations for Rheumatology (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound (US), fluoroscopy, MRI, CT and fusion imaging to guide interventional procedures. Based on evidence and expert opinion, the task force (25 participants consisting of physicians, healthcare professionals and patients from 11 countries) developed PtC, with consensus obtained through voting. The final level of agreement was provided anonymously.ResultsA total of three overarching principles and six specific PtC were formulated. The task force recommends preference of imaging over palpation to guide targeted interventional procedures at peripheral joints, periarticular musculoskeletal structures, nerves and the spine. While US is the favoured imaging technique for peripheral joints and nerves, the choice of the imaging method for the spine and sacroiliac joints has to be individualised according to the target, procedure, expertise, availability and radiation exposure. All imaging guided interventions should be performed by a trained specialist using appropriate operational procedures, settings and assistance by technical personnel.ConclusionThese are the first EULAR PtC to provide guidance on the role of imaging to guide interventional procedures in patients with RMDs.

scholarly journals A Comparison between Multimedia and Traditional Education in Encouraging Adherence to Treatment Regimen in Patients with Hypertension

2020 ◽  
Vol 12 (1) ◽  
pp. 1-6
Author(s):  
Mostafa Bijani ◽  
Banafsheh Tehranineshat ◽  
Fatemeh Ahrari ◽  
Najimeh Beygi
Keyword(s):  
Patient Education ◽  
Treatment Regimen ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Control Group ◽  
Adherence To Treatment ◽  
Educational Approach ◽  
Convenience Sample ◽  
Treatment Regimens ◽  
The Difference

Background: Adherence to treatment regimen plays a crucial part in the prevention of the consequences of hypertension, thus identification and employment of effective educational methods to enhance patients' adherence to their treatment plans is important. Objective: The present study compares the effectiveness of multimedia and traditional methods of patient education in persuading patients with hypertension to stick to their treatment regimens. Methods: Conducted in 2019, the present study is an experimental work of research which lasted for 5 months. A convenience sample of 160 patients who visited the clinic and cardiac sections of a hospital located in the south-west of Iran was selected and then randomly divided into an intervention and a control group. The intervention consisted of multimedia education provided in 6 sessions and telephone follow-ups. The control group was given the traditional care. The research instruments were a demographics questionnaire and a medication adherence scale. Data were collected before, immediately after, and one month after the intervention. The collected data were analyzed using SPSS v. 19, independent t-test, and chi-square test. Results: The difference between the adherence to treatment regimen scores of the two groups as calculated immediately after and one month after the intervention was found to be statistically significant (P<0.001). Conclusion: Patient education via multimedia can significantly increase patients' adherence to their treatment regimens. Accordingly, it is recommended that nurses and other healthcare providers utilize this new educational approach to facilitate patient education and enhance adherence to treatment plan in patients with hypertension.

scholarly journals Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 477
Author(s):  
Catherine B. Chan ◽  
Naomi Popeski ◽  
Leah Gramlich ◽  
Marlis Atkins ◽  
Carlota Basualdo-Hammond ◽  
...  
Keyword(s):  
Older Adults ◽  
Design Thinking ◽  
Healthcare Providers ◽  
Community Organizations ◽  
Community Dwelling ◽  
Nutrition Risk ◽  
Intersectoral Cooperation ◽  
Stakeholder Perspectives ◽  
Patient Representatives ◽  
Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

scholarly journals The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology

2017 ◽  
Vol 76 (12) ◽  
pp. 1974-1979 ◽  
Author(s):  
Ingrid Möller ◽  
Iustina Janta ◽  
Marina Backhaus ◽  
Sarah Ohrndorf ◽  
David A Bong ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Anatomic Structure ◽  
Scanning Method ◽  
European League Against Rheumatism ◽  
The Us ◽  
Technological Developments ◽  
Probe Placement

BackgroundIn 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines.ObjectivesTo update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology.MethodsThe project consisted of the following steps: (1) a systematic literature review of MSUS evaluable structures; (2) a Delphi survey among rheumatologist and radiologist experts in MSUS to select MS and non-MS anatomic structures evaluable by US that are relevant to rheumatology, to select abnormalities evaluable by US and to prioritise these pathologies for rheumatology and (3) a nominal group technique to achieve consensus on the US scanning procedures and to produce an electronic illustrated manual (ie, App of these procedures).ResultsStructures from nine MS and non-MS areas (ie, shoulder, elbow, wrist and hand, hip, knee, ankle and foot, peripheral nerves, salivary glands and vessels) were selected for MSUS in rheumatic and musculoskeletal diseases (RMD) and their detailed scanning procedures (ie, patient position, probe placement, scanning method and bony/other landmarks) were used to produce the App. In addition, US evaluable abnormalities present in RMD for each anatomic structure and their relevance for rheumatology were agreed on by the MSUS experts.ConclusionsThis task force has produced a consensus-based comprehensive and practical framework on standardised procedures for MSUS imaging in rheumatology.

scholarly journals Correlation between quality of life and adherence to treatment in hemodialysis patients

2018 ◽  
Vol 8 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Mahin Naderifar ◽  
Mansoureh Zagheri Tafreshi ◽  
Mahnaz Ilkhani ◽  
Magid Reza Akbarizadeh ◽  
Fereshteh Ghaljaei
Keyword(s):  
Quality Of Life ◽  
Healthcare Providers ◽  
Life Quality ◽  
Well Being ◽  
Sample Volume ◽  
Hemodialysis Patients ◽  
Adherence To Treatment ◽  
Medical Sciences ◽  
The Mean

Introduction: Institutionalizing adherence to treatment in hemodialysis patients is one of the important nursing goals for improving quality of life in these patients. Adherence to treatment approach in these patients can play a pivotal role in improving the health level and feeling of well-being. Objectives: This study aimed at determining the quality of life in hemodialysis patients presenting to hemodialysis centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, on the basis of adherence to treatment. Patients and Methods: This is a correlational descriptive-analytic study. The study population consisted of hemodialysis patients in five hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, in 2017. The data were collected during 8 months from October 2016 to May 2017 in Tehran. A sample volume of 200 patients was determined in this study. Demographic information questionnaire, KDQOL-SF, and ESRD-AQ were applied in data collection. Availability sampling method was used to select the samples on the basis of inclusion criteria. The data were analyzed with SPSS version 18 using descriptive and inferential statistics. Results: Our findings showed that 50% of the patients were male. Most of the respondents of the study (23%) were 51-60 years old. The results indicated that the mean score of quality of life of patients was 50.42±22.81. The mean total score of adherence to treatment was 901.13±85.30. Also, the correlation coefficient in this study revealed a significant correlation between total score of quality of life and adherence to treatment (r=0.218, P<0.01). Conclusion: Considering the significant correlation between adherence to treatment and life quality of patients, healthcare providers can promote the life quality of these patients via focusing on planning programs for emphasizing the role of education and interventions that improve adherence to treatment in these patients.

scholarly journals Fair, just and compassionate: A pilot for making allocation decisions for patients requesting experimental drugs outside of clinical trials

2018 ◽  
Vol 44 (11) ◽  
pp. 761-767 ◽  
Author(s):  
Arthur L Caplan ◽  
J Russell Teagarden ◽  
Lisa Kearns ◽  
Alison S Bateman-House ◽  
Edith Mitchell ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Healthcare Providers ◽  
Best Interests ◽  
Ethical Framework ◽  
Compassionate Use ◽  
Medical Needs ◽  
Experimental Drugs ◽  
The Status ◽  
Patient Representatives ◽  
New Treatments

Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee (CompAC). Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice.

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